Monotherapy with oxcarbazepine and controlled-release carbamazepine in newly diagnosed adult focal epilepsy (open comparative study)

Abstract

Introduction. Oxcarbazepine is the first-line therapy for newly diagnosed focal epilepsy in children, but data on its use in adult patients in the Russian population are limited.Aim. Improvement of the efficacy of initial therapy with oxcarbazepine and controlled-release carbamazepine for newly diagnosed focal epilepsy in adults.Patients and methods. The study included 74 adult patients, 39 of them were included in the oxcarbazepine group and 35 in the controlledrelease carbamazepine group. During the 6-month follow-up period, patients completed 5 visits, during which adverse events and effectiveness were assessed, as well as video-EEG monitoring with an assessment of the epileptiform activity index. Results. The proportion of patients with a reduction in seizure frequency of more than 50 % was comparable in both groups, constituting 82.4 % (n = 28) and 85.2 % (n = 23) in the oxcarbazepine and carbamazepine group, respectively. Adverse events developed in 20 % (n = 7) of patients taking carbamazepine, and in the oxcarbazepine group in 12.8 % (n = 5) of patients. The 6-month initial monotherapy retention rate was higher in oxcarbazepine group (71.8 %) compared to carbamazepine group (65.7 %). In both groups, a 2.0–3.5-fold decrease in the average and total epileptiform activity index and epileptiform activity index during sleep was registered.Conclusions. The obtained results indicate similar effectiveness of oxcarbazepine and controlled-release carbamazepine in the treatment of newly diagnosed focal epilepsy in adults and better tolerability of oxcarbazepine in terms of both adverse events rate and lower frequency of drug discontinuation due to adverse events. A decrease in the epileptiform activity index by 2.0–3.5 times is evidence of possible use of the epileptiform activity index as an objective marker of the disease dynamics