Efficacy and safety of ketogenic diet,anakinra,and tocilizumab in treatment of febrile infection-related epilepsy syndrome in the acute stage
10.13406/j.cnki.cyxb.003754
- VernacularTitle:生酮饮食、阿那白滞素及托珠单抗治疗急性期热性感染相关性癫痫综合征的疗效及安全性分析
- Author:
Wei LIU
1
;
Jiong DENG
;
Tian SANG
;
Jie ZHANG
Author Information
1. 北京大学第一医院儿童医学中心,北京 100034
- Keywords:
ketogenic diet;
anakinra;
tocilizumab;
febrile infection-related epilepsy syndrome
- From:
Journal of Chongqing Medical University
2025;50(3):293-302
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficacy and safety of ketogenic diet,anakinra,and tocilizumab in the treatment of febrile infection-related epilepsy syndrome(FIRES)through a meta-analysis.Methods:With FIRES,ketogenic diet,anakinra,and tocili-zumab as search terms,the databases of PubMed,Embase,Web of Science,the Cochrane Library,Clinicalttrials.gov,CNKI,Wanfang Data,and VIP were searched for related articles published up to December 13,2024.Two reviewers independently screened the ar-ticles according to the inclusion and exclusion criteria and assessed the risk of bias of the studies included.Review Manager was used to perform the meta-analysis.Results:Among the 549 studies,45 case reports and case series met the inclusion criteria,and there were 45 retrospective studies in total,among which 25,8,and 17 were included in the ketogenic diet group,the tocilizumab group,and the anakinra group,respectively,with 66 patients in the ketogenic diet group,8 in the the tocilizumab group,and 54 in the anakinra group.There were 3 case reports,in which all 3 patients were treated with tocilizumab and anakinra.The meta-analysis showed that in the treatment of FIRES in the acute stage,ketogenic diet,anakinra,and tocilizumab showed a response raet of 68%(95%CI=51%-85%,I 2=71%,P<0.01),57%(95%CI=35%-80%,I 2=71%,P<0.01),and 100%(95%CI=79%-100%,I 2=0%,P=1.00),respec-tively,with no statistical differences between studies.The survival rate was 96%(95%CI=89%-100%,I 2=0%,P=1.00)in the keto-genic diet group,96%(95%CI=89%-100%,I 2=0%,P=1.00)in the FIRES,and ketogenic diet and anakinra treatment have a relatively high incidence rate of adverse reactions.Hypoglycemia and infec-tion are adverse reactions commonly observed during treatment.
