Prescription patterns of antiseizure drugs in tuberous sclerosis complex (TSC)-associated epilepsy: a multicenter cohort study from Germany and review of the literature

Strzelczyk A, Grau J, Bast T, Bertsche A, Bettendorf U, Hahn A, Hartmann H, Hertzberg C, Hornemann F, Immisch I, Jacobs J, Klotz KA, Kluger G, Knake S, Knuf M, Kurlemann G, Marquard K, Mayer T, Meyer S, Muhle H, Mueller-Schlueter K, Von Podewils F, Rosenow F, Ruf S, Sauter M, Schaefer H, Schlump JU, Schubert-Bast S, Syrbe S, Thiels C, Trollmann R, Wiemer-Kruel A, Wilken B, Zukunft B, Zoellner JP (2021)

Publication Type: Journal article, Review article

Publication year: 2021

Journal

DOI: 10.1080/17512433.2021.1911643

Abstract

Objective Seizures are a primary and early disease manifestation of Tuberous Sclerosis Complex (TSC). We aimed to describe the age-stratified patterns of antiseizure drug (ASD) treatments among children, adolescents, and adults with TSC in Germany. Additionally, we reviewed real-world and clinical study evidence regarding ASD utilization in patients with TSC. Methods We evaluated the pattern of routine ASD use and everolimus prescriptions based on a 2019 multicenter survey of 268 individuals with TSC-associated epilepsy. We contextualized the results with a structured review of real-world and clinical study evidence. Results TSC-associated epilepsy treatment comprises a wide variety of ASDs. In this German sample, the majority of patients were treated with polytherapy, and lamotrigine (34.7%), valproate (32.8%), oxcarbazepine (28.7%), vigabatrin (19.0%), and levetiracetam (17.9%) were identified as the most-commonly used ASDs. In addition, everolimus was used by 32.5% of patients. In adherence to current TSC guidelines, the disease-modifying ASD vigabatrin was widely used in children (58% below the age of 5 years), whereas treatment in adults did not necessarily reflect guideline preference for (partial) GABAergic ASDs. Conclusions The selection of ASDs for patients with TSC-associated epilepsy follows well-evaluated recommendations, including the guidelines regarding vigabatrin use in children. Several characteristics, such as the comparatively high frequency of valproate use and polytherapy, reflect the severity of TSC-associated epilepsy.

Authors with CRIS profile

Involved external institutions

Universitätsmedizin Rostock Germany (DE) Goethe-Universität Frankfurt am Main Germany (DE) HELIOS Kliniken Germany (DE) Albert-Ludwigs-Universität Freiburg Germany (DE) Universität Leipzig Germany (DE) Schön Klinik Vogtareuth Germany (DE) Medizinische Hochschule Hannover (MHH) / Hannover Medical School Germany (DE) Ruppiner Kliniken Germany (DE) Epilepsiezentrum Kork Germany (DE) Universitätsklinikum der Ludwig-Maximilians-Universität München Germany (DE) Christian-Albrechts-Universität zu Kiel Germany (DE) Universitätsklinikum des Saarlandes (UKS) Germany (DE) Universitätsklinikum Heidelberg Germany (DE) Vivantes - Netzwerk für Gesundheit GmbH Germany (DE) Ruhr-Universität Bochum (RUB) Germany (DE) Universität Witten/Herdecke Germany (DE) St. Bonifatius Hospital Germany (DE) Klinikum Stuttgart Germany (DE) Kleinwachau - Sächsisches Epilepsiezentrum Radeberg gGmbH Germany (DE) Justus-Liebig-Universität Gießen Germany (DE) Universitätsmedizin Greifswald / Universitätsklinikum Greifswald Germany (DE) Universitätsklinikum Tübingen Germany (DE) Philipps-Universität Marburg Germany (DE) Klinikum Kassel GmbH Germany (DE) Klinikum Kempten Germany (DE) Charité - Universitätsmedizin Berlin Germany (DE)

How to cite

APA:

Strzelczyk, A., Grau, J., Bast, T., Bertsche, A., Bettendorf, U., Hahn, A.,... Zoellner, J.P. (2021). Prescription patterns of antiseizure drugs in tuberous sclerosis complex (TSC)-associated epilepsy: a multicenter cohort study from Germany and review of the literature. Expert Review of Clinical Pharmacology. https://doi.org/10.1080/17512433.2021.1911643

MLA:

Strzelczyk, Adam, et al. "Prescription patterns of antiseizure drugs in tuberous sclerosis complex (TSC)-associated epilepsy: a multicenter cohort study from Germany and review of the literature." Expert Review of Clinical Pharmacology (2021).

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