Survey results suggest that patients with epilepsy are more concerned with the effectiveness of seizure reduction than with any other treatment outcome of antiepileptic drugs.
SAN ANTONIO—Patients with epilepsy are willing to accept such antiepileptic drug (AED) side effects as long-term confusion or memory problems in exchange for more effective seizure reduction, according to survey results reported at the 64th Annual Meeting of the American Epilepsy Society.
Ranjani Manjunath, MSPH, of GlaxoSmithKline, Research Triangle Park, North Carolina, and colleagues surveyed 263 patients with epilepsy to determine how much importance they attached to various AED treatment outcomes and their willingness to trade off some treatment outcomes for others. The survey included nine questions, each of which presented two hypothetical add-on AEDs with different treatment outcomes, asking participants which hypothetical AED they preferred and whether they would add the preferred hypothetical AED to their current treatment.
The treatment outcomes assessed in the study were number of seizures, short-term side effects, long-term fatigue or moodiness, long-term confusion or memory problems, urinary retention, weight change in six months, frequency of drug dosage, and personal medicine cost.
Seizure Reduction Versus Side Effects
The mean age of patients was 43; about 54% were female, and 90% were non-Hispanic white. On average, subjects were taking two AEDs at present and had tried four AEDs previously. About 60% of participants reported experiencing no seizures in the previous three months, 34% reported experiencing depression, 28% reported experiencing anxiety, and 28% reported experiencing migraine.
On a scale of 1 to 10, the investigators found that the most important AED treatment outcome was seizure reduction (9.8), followed by long-term confusion or memory problems (8.4), weight change (8.1), long-term fatigue or moodiness (4.8), urinary retention (4.7), dosing frequency (1.8), and short-term side effects (0.4).
“Seizure reduction was twice as important as long-term fatigue or moodiness and was 1.4 times more important than weight-gain outcome,” the researchers noted.
Add-On Drugs for Epilepsy Treatment
Overall, the patients expressed a strong preference for maintaining their current treatment regimen. Subjects who were willing to take an add-on AED were more likely to be female, to be older, to keep a seizure diary, and to have had no brain surgery. Those who were unwilling to do so were more likely to have had no seizures in the prior three months, to have had some college education, and to have had a longer duration of epilepsy.
—Jack Baney