Seizure recurrence proportion under antiseizure medication in people living with epilepsy and prolonged seizure remission: A systematic review

IF 2.7 3区医学 Q2 CLINICAL NEUROLOGY

Seizure-European Journal of Epilepsy Pub Date : 2024-11-16 DOI:10.1016/j.seizure.2024.11.006

Tae-Won Yang , Young-Soo Kim , Do-Hyung Kim , Minjung Kim , Minjun Kim , Jung Sook Yeom , Oh-Young Kwon

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引用次数: 0

Abstract

Background and purpose

People living with epilepsy (PLWE) may wish to discontinue antiseizure medications (ASMs) after long-term remission. However, fear of relapse may lead to continued ASM use. Previous studies have focused on seizure relapse in PLWE who discontinued ASMs after long-term seizure remission (PLWE off ASM), with limited data on those who continued ASMs (PLWE on ASM).

Methods

We conducted a systematic review and meta-analysis of studies from five databases. We included studies with adult PLWE on ASM with long-term follow-up, using a common-effect model for analysis.

Results

Seven datasets from six studies were reviewed. Three of the six studies appeared to include some children and adolescents. Significant differences in seizure recurrence proportions (SRP) were found between PLWE whose seizures were controlled on one ASM (PLWE on one ASM) and those whose seizures were controlled on multiple ASMs (PLWE on multiple ASMs) over one to five years of follow-up. After two years, the SRP was 0.1416 for PLWE on one ASM and 0.2479 for PLWE on multiple ASMs. The relative risk (RR) of seizure recurrence for PLWE off ASM compared to PLWE on ASM was 1.9912 after two years, with the RR decreasing over time.

Discussion

Among PLWE on ASM, PLWE on one ASM have a lower chance of seizure recurrence than PLWE on multiple ASMs. PLWE off ASM have twice the risk of recurrence compared to PLWE on ASM after two years. This information aids PLWE in making informed decisions about ASM continuation or discontinuation.

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癫痫患者服用抗癫痫药物后癫痫复发率和长期发作缓解：一项系统综述

背景和目的癫痫患者（PLWE）在长期缓解后可能希望停用抗癫痫药物（asm）。然而，对复发的恐惧可能导致ASM继续使用。先前的研究主要集中在长期癫痫发作缓解后停用ASM的PLWE患者的癫痫复发，而关于继续使用ASM的PLWE患者的数据有限。方法：我们对来自5个数据库的研究进行了系统回顾和荟萃分析。我们纳入了对ASM进行长期随访的成人PLWE研究，使用共同效应模型进行分析。结果回顾了来自6项研究的7个数据集。六项研究中有三项似乎包括了一些儿童和青少年。在1 ~ 5年的随访中，癫痫发作控制在一个ASM上的PLWE与癫痫发作控制在多个ASM上的PLWE在癫痫发作复发率（SRP）上存在显著差异。两年后，一个ASM上PLWE的SRP为0.1416，多个ASM上PLWE的SRP为0.2479。两年后，停药组与停药组癫痫复发的相对危险度（RR）为1.9912，RR随时间的推移而降低。在ASM上的PLWE中，一个ASM上的PLWE比多个ASM上的PLWE有更低的癫痫复发机会。2年后，非ASM PLWE复发的风险是非ASM PLWE复发的两倍。这些信息有助于PLWE对ASM的继续或终止做出明智的决定。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Seizure-European Journal of Epilepsy 医学-临床神经学

CiteScore

5.60

自引率

6.70%

发文量

231

审稿时长

34 days

期刊介绍： Seizure - European Journal of Epilepsy is an international journal owned by Epilepsy Action (the largest member led epilepsy organisation in the UK). It provides a forum for papers on all topics related to epilepsy and seizure disorders.