Araştırma Makalesi
BibTex RIS Kaynak Göster

Is Levetiracetam Monotherapy Effective And Safe In Children With Epilepsy?

Yıl 2022, Cilt: 3 Sayı: 3, 276 - 282, 30.11.2022

Arzu Ekici Sevgi Yimenicioğlu Havva Kaya

https://doi.org/10.48176/esmj.2022.86

Öz

Introduction: Levetiracetam a second-generation antiepileptic drug with a broad spectrum and a wide safety margin, is used in both focal and generalized seizure treatment. In this study, we decided determine efficacy, side effects and safety of levetiracetam monotherapy in children with epilepsy.
Methods: The medical records of consecutive 102 patients who were treated with levetiracetam monotherapy were evaluated retrospectively.
Results: Total of 102 patients on levetiracetam monotherapy, 50 (49%) girls and 52 (51%) boys, were evaluated. Median age of the patients is 121.5 (62.25-178.5) months. Majority of the patients (95.1%) had generalized epilepsy. Twenty-seven (26.5%) patients had concomitant neurological problems. Dosing of levetiracetam was 20-80 mg/kg/day. Twenty eight (27.5%) patients had adverse reactions. The most common side effects were nervousness (10.8%) and enuresis nocturna (3.9%). Nervousness (4.9%), enuresis nocturna (1%) and headache (1%) were the reason for discontinuation. Twenty four (51.1%) of abnormal pre-treatment EEG had recovered and 74 (72.5%) of patients were seizure free after levetiracetam treatment. There was a statistically significant difference between levetiracetam treatment pre- and post-EEG abnormality (p=0.001). All over 10 (9.8%) patients were discontinued the treatment due to adverse effects (n:7, 6.9%) and inefficacy (n:3, 3%) at the 12 month of the treatment. The retention rate was 90.2%.
Conclusion: This study suggests that levetiracetam monotherapy had high percentage of seizure reduction, low rates of serious adverse events and inefficacy, significant difference on pre-treatment EEG recovery in children.

Anahtar Kelimeler

adverse reaction children efficacy epilepsy levetiracetam monotherapy

Kaynakça

  • Referans1. Shinnar S, Pellock JM. Update on the epidemiology and prognosis of pediatric epilepsy. J Child Neurol. 2002;17:1;4-17.
  • Referans2. Fisher RS, Acevedo C, Arzimanoglou A, et al. ILAE official report: a practical clinical definition of epilepsy. Epilepsia. 2014;55:475-82.
  • Referans3. Ben-Menachem E, Falter U for the European Levetiracetam study group. Efficacy and tolerability of levetiracetam 3000 mg/d in patients with refractory partial seizures: A multicenter, double blind, Responder-selected study evaluating monotheraphy. Epilepsia. 2000;4:1276-83.
  • Referans4. Abou-Khalil BW. Update on Antiepileptic Drugs 2019. Continuum (Minneap Minn). 2019;25(2):508-36. Referans5. Lynch BA, Lambeng N, Nocka K. The synaptic vesicle protein SV2A is the binding site for the antiepileptic drug levetiracetam. Proc Natl Acad Sci USA. 2004;101:9861-6.
  • Referans6. Browne TR, Szabo GK, Leppik IE et al. Absence of pharmacokinetic drug interaction of levetiracetam with phenytoin in patients with epilepsy determined by new technique. J Clin Pharmacol. 2000;40(6):590-5.
  • Referans7. Otoul C, De Smedt H, Stockis A. Lack of pharmacokinetic interaction of levetiracetam on carbamazepine, valproic acid, topiramate, and lamotrigine in children with epilepsy. Epilepsia. 2007;48(11):2111-5.
  • Referans8. Khurana DS, Kothare SV, Valencia I, et al. Levetiracetam monotherapy in children with epilepsy. Pediatr Neurol. 2007;36(4):227-30.
  • Referans9. Lagae L, Buyse G, Ceulemans B. Clinical experience with levetiracetam in childhood epilepsy: an add-on and mono-therapy trial. Seizure. 2005;14(1):66-71. Referans10. Tekgül H, Gencpinar P, Çavuşoğlu D, Dündar NO. The efficacy, tolerability and safety of levetiracetam therapy in a pediatric population. Seizure. 2016;36:16-21.
  • Referans11. Lyseng-Williamson KA. Levetiracetam: a review of its use in epilepsy. Drugs. 2011;71(4):489-514.
  • Referans12. Kang BS, Moon HJ, Kim YS, et al. The long-term efficacy and safety of levetiracetam in a tertiary epilepsy centre. Epileptic Disorders. 2013;15:302-10. Referans13. Mazur RD, Wang Ba Q, Kato Bs K, et al. Effectiveness of Levetiracetam Monotherapy in Pediatric Patients With Epilepsy. J Child Neurol. 2019;34:593-7.
  • Referans14. Incecik F, Herguner OM, Besen S, Altunbasak S. Urinary and fecal incontinence during levetiracetam therapy. Ann Indian Acad Neurol. 2015;18:479-80.
  • Referans15. Mbizvo GK, Dixon P, Hutton JL, Marson AG.The adverse effects profile of levetiracetam in epilepsy: a more detailed look. Int J Neurosc. 2014;124(9):627-34.
  • Referans16. Ouyang CS, Chiang CT, Yang RC, Wu RC, Wu HC, Lin LC. .Quantitative EEG findings and response to treatment with antiepileptic medications in children with epilepsy. Brain Dev. 2018;40(1):26-35.
  • Referans17. Sundaram M, Sadler RM, Young GB, Pillay N. EEG in epilepsy: current perspectives. Can J Neurol Sci. 1999;26(4):255-62.
  • Referans18. Arican P, Gencpinar P, Cavusoglu D, Olgac Dundar N. Levetiracetam monotherapy for the treatment of infants with epilepsy. Seizure. 2018;56:73-7.
  • Referans19. Kanemura H, Sano F, Sugita K, Aihara M. Effects of levetiracetam on seizure frequency and neuropsychological impairments in children with refractory epilepsy with secondary bilateral synchrony. Seizure. 2013;22:43-7.
  • Referans20. Depondt C, Yuen AW, Bell GS, et al. The long term retention of levetiracetam in a large cohort of patients with epilepsy. J Neurol Neurosurg Psychiatry. 2006;77(1):101-3.
  • Referans21. Trinka E, Marson AG, Van Paesschen W, et al. KOMET: an unblinded, randomised, two parallel-group, stratified trial comparing the effectiveness of levetiracetam with controlled-release carbamazepine and extended-release sodium valproate as monotherapy in patients with newly diagnosed epilepsy. J Neurol Neurosurg Psychiatry. 2013;84:1138-47.

Epilepsili Çocuklarda Levetirasetam Monoterapisi Etkili Ve Güvenli midir?

Yıl 2022, Cilt: 3 Sayı: 3, 276 - 282, 30.11.2022

Arzu Ekici Sevgi Yimenicioğlu Havva Kaya

https://doi.org/10.48176/esmj.2022.86

Öz

Giriş: Geniş spektrumlu ve geniş güvenlik marjına sahip ikinci nesil bir antiepileptik ilaç olan levetirasetam, hem fokal hem de jeneralize nöbet tedavisinde kullanılmaktadır. Bu çalışmada epilepsili çocuklarda levetirasetam monoterapisinin etkinliğini, yan etkilerini ve güvenliğini belirlemeye karar verdik.
Yöntemler: Levetirasetam monoterapisi ile tedavi edilen ardışık 102 hastanın tıbbi kayıtları geriye dönük olarak değerlendirildi.
Bulgular: Levetirasetam monoterapisi alan 50 (%49) kız ve 52 (%51) erkek toplam 102 hasta değerlendirildi. Hastaların ortanca yaşı 121,5 (62,25-178.5) aydır. Hastaların çoğunluğu (%95.1) jeneralize epilepsi hastasıydı. Yirmi yedi (%26,5) hastada eşlik eden nörolojik problemler vardı. Levetirasetam dozu 20-80 mg/kg/gün idi. Yirmi sekiz (%27.5) hastada yan etkiler görüldü. En sık görülen yan etkiler sinirlilik (%10.8) ve enürezis nokturna (%3.9) idi. Sinirlilik (%4.9), enürezis nokturna (%1) ve baş ağrısı (%1) bırakma nedeniydi. Tedavi öncesi anormal EEG'nin 24'ü (%51.1) düzeldi ve levetirasetam tedavisi sonrası hastaların 74'ü (%72.5) nöbetsiz kaldı. Levetirasetam tedavisi öncesi ve sonrası EEG anormalliği arasında istatistiksel olarak anlamlı fark vardı (p=0,001). 10'dan fazla (%9.8) hastanın tamamı, tedavinin 12. ayında yan etkiler (n:7, %6.9) ve etkisizlik (n:3, %3) nedeniyle tedaviyi bırakmıştır. Elde tutma oranı %90.2 idi.
Sonuç: Bu çalışma, levetirasetam monoterapisinin yüksek oranda nöbet azaltma, düşük ciddi yan etkiler ve etkisizlik oranları, çocuklarda tedavi öncesi EEG iyileşmesi üzerinde anlamlı fark olduğunu göstermektedir.

Anahtar Kelimeler

advers reaksiyon çocuklar etkinlik epilepsi levetirasetam monoterapi

Kaynakça

  • Referans1. Shinnar S, Pellock JM. Update on the epidemiology and prognosis of pediatric epilepsy. J Child Neurol. 2002;17:1;4-17.
  • Referans2. Fisher RS, Acevedo C, Arzimanoglou A, et al. ILAE official report: a practical clinical definition of epilepsy. Epilepsia. 2014;55:475-82.
  • Referans3. Ben-Menachem E, Falter U for the European Levetiracetam study group. Efficacy and tolerability of levetiracetam 3000 mg/d in patients with refractory partial seizures: A multicenter, double blind, Responder-selected study evaluating monotheraphy. Epilepsia. 2000;4:1276-83.
  • Referans4. Abou-Khalil BW. Update on Antiepileptic Drugs 2019. Continuum (Minneap Minn). 2019;25(2):508-36. Referans5. Lynch BA, Lambeng N, Nocka K. The synaptic vesicle protein SV2A is the binding site for the antiepileptic drug levetiracetam. Proc Natl Acad Sci USA. 2004;101:9861-6.
  • Referans6. Browne TR, Szabo GK, Leppik IE et al. Absence of pharmacokinetic drug interaction of levetiracetam with phenytoin in patients with epilepsy determined by new technique. J Clin Pharmacol. 2000;40(6):590-5.
  • Referans7. Otoul C, De Smedt H, Stockis A. Lack of pharmacokinetic interaction of levetiracetam on carbamazepine, valproic acid, topiramate, and lamotrigine in children with epilepsy. Epilepsia. 2007;48(11):2111-5.
  • Referans8. Khurana DS, Kothare SV, Valencia I, et al. Levetiracetam monotherapy in children with epilepsy. Pediatr Neurol. 2007;36(4):227-30.
  • Referans9. Lagae L, Buyse G, Ceulemans B. Clinical experience with levetiracetam in childhood epilepsy: an add-on and mono-therapy trial. Seizure. 2005;14(1):66-71. Referans10. Tekgül H, Gencpinar P, Çavuşoğlu D, Dündar NO. The efficacy, tolerability and safety of levetiracetam therapy in a pediatric population. Seizure. 2016;36:16-21.
  • Referans11. Lyseng-Williamson KA. Levetiracetam: a review of its use in epilepsy. Drugs. 2011;71(4):489-514.
  • Referans12. Kang BS, Moon HJ, Kim YS, et al. The long-term efficacy and safety of levetiracetam in a tertiary epilepsy centre. Epileptic Disorders. 2013;15:302-10. Referans13. Mazur RD, Wang Ba Q, Kato Bs K, et al. Effectiveness of Levetiracetam Monotherapy in Pediatric Patients With Epilepsy. J Child Neurol. 2019;34:593-7.
  • Referans14. Incecik F, Herguner OM, Besen S, Altunbasak S. Urinary and fecal incontinence during levetiracetam therapy. Ann Indian Acad Neurol. 2015;18:479-80.
  • Referans15. Mbizvo GK, Dixon P, Hutton JL, Marson AG.The adverse effects profile of levetiracetam in epilepsy: a more detailed look. Int J Neurosc. 2014;124(9):627-34.
  • Referans16. Ouyang CS, Chiang CT, Yang RC, Wu RC, Wu HC, Lin LC. .Quantitative EEG findings and response to treatment with antiepileptic medications in children with epilepsy. Brain Dev. 2018;40(1):26-35.
  • Referans17. Sundaram M, Sadler RM, Young GB, Pillay N. EEG in epilepsy: current perspectives. Can J Neurol Sci. 1999;26(4):255-62.
  • Referans18. Arican P, Gencpinar P, Cavusoglu D, Olgac Dundar N. Levetiracetam monotherapy for the treatment of infants with epilepsy. Seizure. 2018;56:73-7.
  • Referans19. Kanemura H, Sano F, Sugita K, Aihara M. Effects of levetiracetam on seizure frequency and neuropsychological impairments in children with refractory epilepsy with secondary bilateral synchrony. Seizure. 2013;22:43-7.
  • Referans20. Depondt C, Yuen AW, Bell GS, et al. The long term retention of levetiracetam in a large cohort of patients with epilepsy. J Neurol Neurosurg Psychiatry. 2006;77(1):101-3.
  • Referans21. Trinka E, Marson AG, Van Paesschen W, et al. KOMET: an unblinded, randomised, two parallel-group, stratified trial comparing the effectiveness of levetiracetam with controlled-release carbamazepine and extended-release sodium valproate as monotherapy in patients with newly diagnosed epilepsy. J Neurol Neurosurg Psychiatry. 2013;84:1138-47.
Toplam 18 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makaleleri
Yazarlar

Arzu Ekici 0000-0002-0813-7189

Sevgi Yimenicioğlu 0000-0002-1598-4423

Havva Kaya 0000-0001-6423-9262

Yayımlanma Tarihi 30 Kasım 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 3 Sayı: 3

Kaynak Göster

APA Ekici, A., Yimenicioğlu, S., & Kaya, H. (2022). Is Levetiracetam Monotherapy Effective And Safe In Children With Epilepsy?. Eskisehir Medical Journal, 3(3), 276-282. https://doi.org/10.48176/esmj.2022.86
AMA Ekici A, Yimenicioğlu S, Kaya H. Is Levetiracetam Monotherapy Effective And Safe In Children With Epilepsy?. Eskisehir Med J. Kasım 2022;3(3):276-282. doi:10.48176/esmj.2022.86
Chicago Ekici, Arzu, Sevgi Yimenicioğlu, ve Havva Kaya. “Is Levetiracetam Monotherapy Effective And Safe In Children With Epilepsy?”. Eskisehir Medical Journal 3, sy. 3 (Kasım 2022): 276-82. https://doi.org/10.48176/esmj.2022.86.
EndNote Ekici A, Yimenicioğlu S, Kaya H (01 Kasım 2022) Is Levetiracetam Monotherapy Effective And Safe In Children With Epilepsy?. Eskisehir Medical Journal 3 3 276–282.
IEEE A. Ekici, S. Yimenicioğlu, ve H. Kaya, “Is Levetiracetam Monotherapy Effective And Safe In Children With Epilepsy?”, Eskisehir Med J, c. 3, sy. 3, ss. 276–282, 2022, doi: 10.48176/esmj.2022.86.
ISNAD Ekici, Arzu vd. “Is Levetiracetam Monotherapy Effective And Safe In Children With Epilepsy?”. Eskisehir Medical Journal 3/3 (Kasım 2022), 276-282. https://doi.org/10.48176/esmj.2022.86.
JAMA Ekici A, Yimenicioğlu S, Kaya H. Is Levetiracetam Monotherapy Effective And Safe In Children With Epilepsy?. Eskisehir Med J. 2022;3:276–282.
MLA Ekici, Arzu vd. “Is Levetiracetam Monotherapy Effective And Safe In Children With Epilepsy?”. Eskisehir Medical Journal, c. 3, sy. 3, 2022, ss. 276-82, doi:10.48176/esmj.2022.86.
Vancouver Ekici A, Yimenicioğlu S, Kaya H. Is Levetiracetam Monotherapy Effective And Safe In Children With Epilepsy?. Eskisehir Med J. 2022;3(3):276-82.
 Kapak Resmi İndir