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Drug regimens in patients with medication-resistant epilepsy in neurology and epilepsy outpatient departments in Spain

M. Rufo-Campos, J. Sancho-Rieger, P. Peña, X. Masramon, J. Rejas-Gutiérrez, Grupo de colaboradores del estudio LINCE [REV NEUROL 2008;47:517-524] PMID: 19012255 DOI: https://doi.org/10.33588/rn.4710.2008409

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Volumen 47 | Number 10 | Nº of views of the article 6.003 | Nº of PDF downloads 1.630 | Article publication date 16/11/2008

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ABSTRACT

INTRODUCTION About 30% of epileptic patients suffer from drug-resistant epilepsy (DRE). Quality of life is worse and costs are higher than in controlled epilepsy. One of the aims of the LINCE study was to assess the prevalence of DRE in epilepsy-specialized and general neurology clinics in Spain and the clinical management of these patients in routine clinical practice.

PATIENTS AND METHODS Cross-sectional, retrospective study to evaluate clinical prevalence and cost of DRE in Spain. Every participant neurologist assessed the percentage of DRE among the first 40 patients with diagnosed epilepsy seen. Patients of both sexes, older than 18 years were recruited. Their treatment before and after DRE diagnosis was analyzed.

RESULTS DRE prevalence in Spain is 22.7% (36% in epilepsy-specialized and 18.5% in neurology clinics; p < 0.0001), with no differences between genders. More than 50% of these patients have hardly achieved a secondary education and only 44% are employed. The most frequent drugs used after DRE diagnosis are lamotrigine (33.5%), levetiracetam (32.4%), carbamazepine (31.9%) and topiramate (25.8%) in various combinations, but the highest efficacy (equal or more than 50% seizures reduction) is obtained with pregabaline (53.1%), oxcarbazepine (50.6%) and levetiracetam (49.5%) and topiramate (48%).

CONCLUSIONS 22.7% of epileptic outpatients in Spain are diagnosed with DRE in clinics of neurology. These will require certain social interventions and greater use of health resources, including treatment with more appropriate AEDs. Pregabaline, oxcarbazepine, levetiracetam and topiramate are among the most effective AEDs in this type of patients. KeywordsAntiepileptic drugs Efficacy LINCE study Prevalence Refractory epilepsy CategoriesEpilepsias y síndromes epilépticos

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Drug regimens in patients with medication-resistant epilepsy in neurology and epilepsy outpatient departments in Spain

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