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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; Muller-Schluter, K; von Podewils, F; Rosenow, F; Ruf, S; Sauter, M; Schafer, H; Schlump, JU; Schubert-Bast, S; Syrbe, S; Thiels, C; Trollmann, R; Wiemer-Kruel, A; Wilken, B; Zukunft, B; Zollner, JP
Expert Rev Clin Pharmacol. 2021; 14(6):749-760
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PMU-Autor/inn/en

Kluger Gerhard

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.
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.
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.
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.


Useful keywords (using NLM MeSH Indexing)

Adolescent

Age Factors

Anticonvulsants/administration*

dosage*

Child

Child, Preschool

Cohort Studies

Cross-Sectional Studies

Epilepsy/drug therapy*

Epilepsy/etiology

Everolimus/administration*

dosage

Germany

Humans

Infant

Infant, Newborn

Practice Patterns, Physicians"

Tuberous Sclerosis/complications

Tuberous Sclerosis/drug therapy*

Young Adult


Find related publications in this database (Keywords)

Epilepsy
seizure
antiepileptic drug
vigabatrin
mTOR inhibitor
medication
prescription pattern
rare disease