非胺酸盐作为耐药遗传性全面性癫痫的治疗选择：一项系统回顾和荟萃分析。

IF 2.7 4区医学 Q2 CLINICAL NEUROLOGY

Neurological Sciences Pub Date : 2025-04-01 Epub Date: 2024-12-26 DOI:10.1007/s10072-024-07942-6

Yitao Ma, Matthew Kaminski, Robert Crutcher

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引用次数: 0

摘要

非胺酸酯（FBM）对遗传性广泛性癫痫（GGE）的影响在很大程度上仍然未知。由于其潜在的再生障碍性贫血和肝功能衰竭的风险，FBM的使用受到限制。本研究旨在综合评价FBM治疗耐药GGE的疗效和安全性。方法：我们检索PubMed、Web of Science、Embase和谷歌Scholar等数据库，确定用FBM治疗的GGE病例。结果和不良事件的数据从这些研究中提取。结果：文献检索获得9篇研究共166例，FBM作为辅助治疗耐药GGE。FBM的总有效率为65%（95%置信区间CI， 51-80）。17% （95% CI, 3-31）患者实现癫痫发作自由。81% （95% CI, 60-100）伴有肌阵挛性无张力发作的癫痫患者有应答。40%的患者报告了不良事件（95% CI, 26-54）。结论：耐药GGE患者对FBM治疗效果良好。研究之间的高度异质性要求进行进一步的大规模随机对照试验研究。鉴于再生障碍性贫血和肝功能衰竭的特殊反应的罕见报道，建议加强实验室监测和较慢的滴定时间表。

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Felbamate as a therapeutic alternative to drug-resistant genetic generalized epilepsy: a systematic review and meta-analysis.

Introduction: The effect of felbamate (FBM) on genetic generalized epilepsy (GGE) remains largely unknown. The utilization of FBM has been limited due to its potential risk of aplastic anemia and hepatic failure. This study aimed to comprehensively evaluate the efficacy and safety of FBM in the treatment of drug-resistant GGE.

Methods: We searched the databases, including PubMed, Web of Science, Embase, and Google Scholar, to identify cases of GGE treated with FBM. Data on outcomes and adverse events were extracted from these studies.

Results: The literature search yielded 9 studies with 166 cases in which FBM was used as an adjunct therapy to treat drug-resistant GGE. The pooled responder rate to FBM was 65% (95% confidence interval CI, 51-80). 17% (95% CI, 3-31) achieved seizure freedom. 81% (95% CI, 60-100) of patients with Epilepsy with myoclonic atonic seizures were responders. Adverse events were reported in 40% (95% CI, 26-54) of patients.

Conclusions: Patients with drug-resistant GGE achieved good responses to FBM. The high heterogeneity between studies calls for further research with large-scale, randomized controlled trials. Given the rare reports of idiosyncratic reactions of aplastic anemia and hepatic failure, intense laboratory monitoring and a slower titration schedule are recommended.

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来源期刊

Neurological Sciences 医学-临床神经学

CiteScore

6.10

自引率

3.00%

发文量

743

审稿时长

4 months

期刊介绍： Neurological Sciences is intended to provide a medium for the communication of results and ideas in the field of neuroscience. The journal welcomes contributions in both the basic and clinical aspects of the neurosciences. The official language of the journal is English. Reports are published in the form of original articles, short communications, editorials, reviews and letters to the editor. Original articles present the results of experimental or clinical studies in the neurosciences, while short communications are succinct reports permitting the rapid publication of novel results. Original contributions may be submitted for the special sections History of Neurology, Health Care and Neurological Digressions - a forum for cultural topics related to the neurosciences. The journal also publishes correspondence book reviews, meeting reports and announcements.