A real‐world comparison among third‐generation antiseizure medications: Results from the <scp>COMPARE</scp> study-Reference-Cited by-同舟云学术

A real‐world comparison among third‐generation antiseizure medications: Results from the COMPARE study

Published:2023-12-16 Issue: Volume: Page:
ISSN:0013-9580
Container-title:Epilepsia
language:en
Short-container-title:Epilepsia

Author:

Roberti Roberta¹,Di Gennaro Gianfranco¹,Anzellotti Francesca²^ORCID,Arnaldi Dario³⁴,Belcastro Vincenzo⁵,Beretta Simone⁶,Boero Giovanni⁷,Bonanni Paolo⁸,Canafoglia Laura⁹^ORCID,D'Aniello Alfredo¹⁰,Dainese Filippo¹¹,De Caro Carmen¹,Di Gennaro Giancarlo¹⁰,Di Giacomo Roberta¹²^ORCID,DiFrancesco Jacopo C.⁶^ORCID,Dono Fedele²¹³^ORCID,Falcicchio Giovanni¹⁴^ORCID,Ferlazzo Edoardo¹⁵¹⁶,Foschi Nicoletta¹⁷,Franciotta Silvia¹¹,Gambardella Antonio¹⁸^ORCID,Giordano Alfonso¹⁹,Iannone Luigi Francesco²⁰,Labate Angelo²¹^ORCID,La Neve Angela¹⁴,Lattanzi Simona¹⁷^ORCID,Leggio Ugo²²,Liguori Claudio²³²⁴^ORCID,Maschio Marta²⁵,Nilo Annacarmen²⁶^ORCID,Operto Francesca Felicia²⁷^ORCID,Pascarella Angelo¹⁵¹⁶^ORCID,Pauletto Giada²⁸,Renna Rosaria²⁹,Strigaro Gionata³⁰³¹,Russo Emilio¹^ORCID,

Affiliation:

1. Science of Health Department, School of Medicine Magna Græcia University of Catanzaro Catanzaro Italy

2. Department of Neurology Epilepsy Center, SS Annunziata Hospital Chieti Italy

3. Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Clinical Neurology University of Genoa Genoa Italy

4. IRCSS Ospedale Policlinico San Martino Genoa Italy

5. Neurology Unit Maggiore Hospital, ASST Lodi Lodi Italy

6. Department of Neurology Fondazione IRCCS San Gerardo dei Tintori Monza Italy

7. Complex Structure of Neurology SS Annunziata Hospital Taranto Italy

8. Epilepsy and Clinical Neurophysiology Unit Scientific Institute, IRCCS Eugenio Medea Conegliano Treviso Italy

9. Integrated Diagnostics for Epilepsy Fondazione IRCCS Istituto Neurologico Besta Milan Italy

10. IRCCS Neuromed Pozzilli Italy

11. Clinical Neurophysiology Unit Clinical Neurology, DIDAS Department Padua Italy

12. Epilepsy Unit Fondazione IRCCS Istituto Neurologico Besta Milan Italy

13. Department of Neuroscience, Imaging and Clinical Science D'Annunzio University of Chieti‐Pescara Chieti Italy

14. DiBraiN Department University of Bari Aldo Moro Bari Italy

15. Department of Medical and Surgical Sciences Magna Græcia University of Catanzaro Catanzaro Italy

16. Regional Epilepsy Center Bianchi‐Melacrino‐Morelli Great Metropolitan Hospital Reggio Calabria Italy

17. Neurological Clinic, Department of Experimental and Clinical Medicine Marche Polytechnic University Ancona Italy

18. Department of Medical and Surgical Sciences, Institute of Neurology Magna Græcia University of Catanzaro Catanzaro Italy

19. Department of Advanced Medical and Surgical Sciences University of Campania Luigi Vanvitelli Naples Italy

20. Section of Clinical Pharmacology and Oncology, Department of Health Sciences University of Florence Florence Italy

21. Neurophysiopathology and Movement Disorders Clinic University of Messina Messina Italy

22. Unit of Neurophysiopathology ASST Spedali Civili Brescia Italy

23. Department of Systems Medicine University of Rome Tor Vergata Rome Italy

24. Neurology Unit, Epilepsy Center University Hospital Tor Vergata Rome Italy

25. Center for Tumor‐Related Epilepsy, UOSD Neuro‐Oncology IRCCS Regina Elena National Cancer Institute Rome Italy

26. Clinical Neurology Unit, Department of Head, Neck, and Neurosciences Santa Maria della Misericordia University Hospital Udine Italy

27. Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery, and Dentistry University of Salerno Fisciano Italy

28. Neurology Unit, Department of Head, Neck, and Neurosciences Santa Maria della Misericordia University Hospital Udine Italy

29. Neurology and Stroke Unit, Department of Emergency and Acceptance AORN Antonio Cardarelli Hospital Naples Italy

30. Neurology Unit, Department of Translational Medicine, Epilepsy Center University of Piemonte Orientale Novara Italy

31. Maggiore della Carità University Hospital Novara Italy

Abstract

AbstractObjectiveThere are few comparative data on the third‐generation antiseizure medications (ASMs). We aimed to assess and compare the effectiveness of brivaracetam (BRV), eslicarbazepine acetate (ESL), lacosamide (LCM), and perampanel (PER) in people with epilepsy (PWE). Efficacy and tolerability were compared as secondary objectives.MethodsThis multicenter, retrospective study collected data from 22 Italian neurology/epilepsy centers. All adult PWE who started add‐on treatment with one of the studied ASMs between January 2018 and October 2021 were included. Retention rate was established as effectiveness measure and described using Kaplan–Meier curves and the best fitting survival model. The responder status and the occurrence of adverse events (AEs) were used to evaluate efficacy and safety, respectively. The odds of AEs and drug efficacy were estimated by two multilevel logistic models.ResultsA total of 960 patients (52.92% females, median age = 43 years) met the inclusion criteria. They mainly suffered from structural epilepsy (52.29%) with monthly (46.2%) focal seizures (69.58%). Compared with LCM, all the studied ASMs had a higher dropout risk, statistically significant in the BRV levetiracetam (LEV)‐naïve (hazard ratio [HR] = 1.97, 95% confidence interval [CI] = 1.17–3.29) and PER groups (HR = 1.64, 95% CI = 1.06–2.55). Women were at higher risk of discontinuing ESL (HR = 5.33, 95% CI = 1.71–16.61), as well as PER‐treated patients with unknown epilepsy etiology versus those with structural etiology (HR = 1.74, 95% CI = 1.05–2.88). BRV with prior LEV therapy showed lower odds of efficacy (odds ratio [OR] = .08, 95% CI = .01–.48) versus LCM, whereas a higher efficacy was observed in women treated with BRV and LEV‐naïve (OR = 10.32, 95% CI = 1.55–68.78) versus men. PER (OR = 6.93, 95% CI = 3.32–14.44) and BRV in LEV‐naïve patients (OR = 6.80, 95% CI = 2.64–17.52) had a higher chance of AEs than LCM.SignificanceComparative evidence from real‐world studies may help clinicians to tailor treatments according to patients' demographic and clinical characteristics.

Publisher

Wiley

Subject

Neurology (clinical),Neurology

Link

https://onlinelibrary.wiley.com/doi/pdf/10.1111/epi.17843

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