Seizure management and prescription patterns of anticonvulsants in Dravet syndrome: A multicenter cohort study from Germany and review of literature

Schubert-Bast S, Wolff M, Wiemer-Kruel A, von Spiczak S, Trollmann R, Reif PS, Pritchard C, Polster T, Neubauer BA, Mayer T, Macdonald D, Kurlemann G, Kluger G, Klein KM, Kieslich M, Kay L, Kalski M, Irwin J, Herting A, Carroll J, Bettendorf U, Bast T, Rosenow F, Strzelczyk A (2019)

Publication Type: Journal article

Publication year: 2019

Journal

Epilepsy and Behavior Elsevier

Book Volume: 98

Pages Range: 88-95

DOI: 10.1016/j.yebeh.2019.06.021

Abstract

Objective: The aim of this study was to describe the treatment pattern of patients with Dravet syndrome (DS) in Germany with routine antiepileptic drugs (AEDs) and emergency medication, and to review the literature of real-world evidence on medicine utilization of patients with DS in Europe. Methods: Patient use of routine AEDs and emergency medications over 3–6 months was analyzed from a 2018 multicenter survey of 93 caregivers of patients with DS throughout Germany. Results were contextualized in a review of real-world evidence on medicine utilization of patients with DS in Europe. Results: The variety of medications and the most frequent combinations routinely used by patients with DS (AEDs and others) are described. Patients use a large number of pharmaceutical treatments to manage seizures. The five most commonly used AEDs were sodium valproate (66% of the patients; mean daily dose: 660 mg; 24.5 mg per kg bodyweight), bromide (44%; 1462 mg; 51.2 mg per kg), clobazam (41%; 10.4 mg; 0.32 mg per kg), stiripentol (35%; 797 mg; 27.6 mg per kg), and topiramate (24%; 107 mg; 3.5 mg per kg). Ninety percent had reported using emergency medications in the last 3 months;, with the most common medications being Buccolam (40%, an oromucosal form of midazolam) and diazepam (20%, mostly rectal application). No discernable relationships between current medication and age or seizure frequency were observed. Significance: This is the first comprehensive report of routine AEDs and emergency medication use in a large sample of patients with DS in Germany over a period of 3–6 months and shows that despite the most common AED combinations being in line with clinical guidelines/best practice, there is no discernable impact of best treatment on seizure frequency. We find a higher use of bromide in Germany compared with other real-world evidence in Europe.

Authors with CRIS profile

Regina Trollmann Professur für Kinder- u. Jugendmedizin Schwerpunkt Neuropädiatrie

Involved external institutions

Goethe-Universität Frankfurt am Main DE Germany (DE) Epilepsiezentrum Kork DE Germany (DE) Wickenstones GB United Kingdom (GB) Zogenix International, Ltd. GB United Kingdom (GB) Eberhard Karls Universität Tübingen DE Germany (DE) Schön Kliniken DE Germany (DE) Bethel Epilepsy Center DE Germany (DE) Kleinwachau - Sächsisches Epilepsiezentrum Radeberg gGmbH DE Germany (DE) Justus-Liebig-Universität Gießen DE Germany (DE) Westfälische Wilhelms-Universität (WWU) Münster DE Germany (DE) Norddeutsches Epilepsiezentrum Raisdorf DE Germany (DE)

How to cite

APA:

Schubert-Bast, S., Wolff, M., Wiemer-Kruel, A., von Spiczak, S., Trollmann, R., Reif, P.S.,... Strzelczyk, A. (2019). Seizure management and prescription patterns of anticonvulsants in Dravet syndrome: A multicenter cohort study from Germany and review of literature. Epilepsy and Behavior, 98, 88-95. https://dx.doi.org/10.1016/j.yebeh.2019.06.021

MLA:

Schubert-Bast, Susanne, et al. "Seizure management and prescription patterns of anticonvulsants in Dravet syndrome: A multicenter cohort study from Germany and review of literature." Epilepsy and Behavior 98 (2019): 88-95.

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