左乙拉西坦治疗癫痫和自闭症谱系障碍：安全性、耐受性和有效性分析

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior Pub Date : 2025-08-28 DOI:10.1016/j.yebeh.2025.110678

Jon Allard , William Henley , Brendan McLean , Lance Watkins , Mary Parrett , Sanjeev Rajakulendran , Melissa Maguire , Shan Ellawela , Phil Tittensor , Juliet Bransgrove , Arjune Sen , Rajiv Mohanraj , Many Bagary , Sunil Ram , Sarah Pashley , Rohit Shankar

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引用次数: 0

摘要

目的五分之一的自闭症谱系障碍患者患有癫痫并服用抗癫痫药物（ASM）。然而，ASM对自闭症患者的影响还在研究中。本研究评价左乙拉西坦（LEV）治疗自闭症和癫痫的疗效和耐受性。方法数据来源于英国癫痫研究数据库，该数据库比较了神经发育障碍患者和非神经发育障碍患者的ASM反应。年龄范围为18-50岁，因为没有自闭症研究参与者的LEV超过50岁。12个月ASM数据，包括停药率、癫痫发作频率和不良反应的比较。Fisher精确检验用于评估结果与自闭症之间的单变量相关性，显著性为p <； 0.05。在校正潜在混杂因素（年龄、性别、基线身心健康状况）后，采用Logistic回归评估自闭症组差异。结果在2000年至2020年期间，18家NHS信托机构的175名（18 - 50岁）研究参与者中，有40人患有自闭症。戒断率（P = 0.626）和分组副作用（生理P = 0.165，心理P = 0.791）之间无显著相关性。在单变量分析中，自闭症与LEV的攻击性显著相关，但在考虑多重检验后，这种关联不再显著。疗效与自闭症组之间存在显著的非线性关系（P < 0.001）。本研究支持在自闭症和癫痫患者中使用LEV，因为与非自闭症患者的反应没有差异。然而，它们的功效变化可能不太明显。

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Levetiracetam in epilepsy and autism spectrum disorder: analysis of safety, tolerability, and efficacy

Purpose

One in five people with autism spectrum disorder have epilepsy and take Anti-Seizure Medications (ASM). However, the impact of ASM on people with autism is under researched. This study evaluates the efficacy and tolerability of Levetiracetam (LEV) for autistic people and epilepsy.

Method

Data was derived from the English Epilepsy Research Database Register which compares ASM responses in those with neurodevelopmental disorders to those without. Age range was 18–50 years as there were no autistic research participants with autism prescribed LEV over 50. Twelve-month ASM data, including withdrawal rate, seizure frequency and adverse effects were compared. Fisher’s exact test was used to assess univariate associations between outcomes and autism with significance accepted as p < 0.05. Logistic regression was used to assess autism group differences after adjustment for potential confounders (age, gender, presence of baseline physical and mental health conditions).

Results

Of 175 (aged 18–50) research participants across 18 NHS Trusts, prescribed LEV between 2000 and 2020, 40 were autistic. There was no significant association between withdrawal rate (P = 0.626), or grouped side effects (physical P = 0.165, mental health P = 0.791). Autism was significantly associated with aggression with LEV in univariable analysis but this association was no longer significant after accounting for multiple testing A significant non-linear relationship between efficacy and the autism group (P < 0.001) was found.

Conclusions

This study supports the use of LEV for people with autism and epilepsy as there is no difference in response noted to those without autism. However, they may have less prominent changes in efficacy.

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来源期刊

Epilepsy & Behavior 医学-行为科学

CiteScore

5.40

自引率

15.40%

发文量

385

审稿时长

43 days

期刊介绍： Epilepsy & Behavior is the fastest-growing international journal uniquely devoted to the rapid dissemination of the most current information available on the behavioral aspects of seizures and epilepsy. Epilepsy & Behavior presents original peer-reviewed articles based on laboratory and clinical research. Topics are drawn from a variety of fields, including clinical neurology, neurosurgery, neuropsychiatry, neuropsychology, neurophysiology, neuropharmacology, and neuroimaging. From September 2012 Epilepsy & Behavior stopped accepting Case Reports for publication in the journal. From this date authors who submit to Epilepsy & Behavior will be offered a transfer or asked to resubmit their Case Reports to its new sister journal, Epilepsy & Behavior Case Reports.