Analysis of three-year retention rate and efficacy of levetiracetam,lamotrigine and valproic acid in patients with newly diagnosed epilepsy
10.3969/j.issn.1004-1648.2024.04.009
- VernacularTitle:左乙拉西坦、拉莫三嗪与丙戊酸单药治疗初诊癫痫患者3年单药保留率及疗效的分析
- Author:
Jie QI
1
;
Jiao ZENG
;
Xiaoli ZHANG
Author Information
1. 453002 新乡医学院第二附属医院神经内科
- Keywords:
single drug retention rate;
antiepileptic drugs;
EEG;
epilepsy
- From:
Journal of Clinical Neurology
2024;37(4):268-273
- CountryChina
- Language:Chinese
-
Abstract:
Objective Compared the 3-year retention rate and efficacy of levetiracetam(LEV),lamotrigine(LTG)and valproic acid(VPA)in patients with newly diagnosed epilepsy.Methods According to the antiepileptic drugs selected for the first time,323 patients with newly diagnosed epilepsy were divided into the LEV group,LTG group and VPA group.They were followed up for more than 3 years by telephone and outpatient clinic.Results There were significant differences in the single drug retention rate and epileptiform discharge rate among the LEV group,LTG group and VPA group in the first 3 years(all P<0.05).Compared with those in LEV group,the single drug retention rates in LTG group were significantly decreased in the first year and the second year(χ2=6.265,χ2=5.376;all P<0.025),the epileptiform discharge rate were significantly increased in the first year and the second year(χ2=14.011,χ2=8.574;all P<0.025);the single drug retention rate in VPA group were significantly decreased in the second year and the third year(χ2=6.226,χ2=10.112;all P<0.025),the epileptiform discharge rate was significantly increased in the first year,the second year and the third year(χ2=11.504,χ2=14.206,χ2=7.596;all P<0.025).There were significant differences in the survival curve of single drug retention and epileptiform discharge among the LEV group,LTG group and VPA group(χ2=9.349,P<0.05;χ2=7.395,P<0.05).The survival curve of single drug retention in LEV group was significantly higher than that in LTG group(χ2=4.451,P<0.05)and VPA group(χ2=9.464,P<0.05).The survival curve of epileptiform discharge in LEV group was significantly lower than that in VPA group(χ2=7.523,P<0.05).There was no significant difference in drug effective rate and no epileptic seizure rate in the first 3 years between LEV group,LTG group and VPA group(all P>0.05).There was a significant difference in the incidence of adverse drug reactions among the LEV group,LTG group and VPA group(χ2=8.068,P=0.018).Compared with that in LEV group,the incidence of adverse drug reactions in LTG group and VPA group were significantly increased(χ2=6.153,P=0.013;χ2=7.109,P=0.008).The main reasons for drug withdrawal,drug addiction and dressing change in LEV group were unsatisfactory curative effects,while those in LTG group and VPA group were adverse drug reactions.Conclusion The 3-year single drug retention rate of LEV is higher than that of LTG and VPA,and the EEG epileptiform discharge rate and the incidence of adverse drug reactions are significantly reduced,which was more suitable as the first choice for single drug treatment in patients with newly diagnosed epilepsy.
