研究再度證實,在接受三種抗癲癇藥物無效後,將藥物增加至九種不同藥物或藥物組合後,

只有不到1%的患者,癲癇發作終於獲得控制。

想想看,這麼低的治療比率,加上多種抗癲癇藥物帶來的副作用,是不是值得繼續等待奇蹟??

還是選擇跟醫師討論藥物之外的輔助治療方法可能性??

medicine  

May 9, 2012 -- Half of all epilepsy patients who are initially started on one anti-seizure drug remain seizure-free for at least a year, a new study confirms.

201259日 – 新研究證實,在接受抗癲癇藥物治療的第一年,有一半以上的患者,癲癇停止發作。

Among patients followed for as long as 26 years, initial response to drug treatments strongly predicted future seizure control.

追蹤這些患者長達26年的結果發現,一開始的藥物治療成效與將來的癲癇控制成果,息息相關。

Yet less than 1% of patients who failed to respond to three anti-seizure drug regimens achieved adequate seizure control on subsequent drug treatments even though some were treated with as many as nine different drugs or drug combinations.

只有不到1%的患者,在使用三種抗癲癇藥物無效後,將藥物增加至九種不同抗癲癇藥物或藥物組合後,癲癇發作終於獲得控制。

The findings make it clear that epilepsy patients who are candidates for surgery or other non-drug treatments should be considered for these procedures earlier rather than later, says neurologist Patricia E. Penovich, MD, of the University of Minnesota and the Minnesota Epilepsy Group in St. Paul.

美國明尼蘇達州癲癇醫學中心,Patricia 教授指出,這項研究更清楚的讓大家了解,當使用三種藥物以上無效的癲癇患者,就應該立即尋找藥物之外的輔助之療方法或開刀手術,而且越早治療效果越好。

"These patients don't have to wait until they have failed five or six different drug regimens," she tells WebMD. "If their seizures are not controlled by the first few medications it is reasonable to consider surgery."

她說: 當一開始的藥物治療無效後,就應該可慮手術方式等輔助治療方式,而不是等到第五或第六種藥物療程失敗結束後,才選擇其他治療方式。

A Visual Guide to Epilepsy

More Than a Dozen Anti-Seizure Drugs

Roughly 2.7 million Americans have epilepsy, and about 1 in 10 people will experience a seizure at some point in their lifetime, according to the Epilepsy Foundation.

根據癲癇基金會預估,美國有約270萬名癲癇患者,十位民眾中有一人,一生中在某個時刻會經歷癲癇發作。

More than a dozen different drugs can be used to control seizures, and decisions about which medication to try first are made by considering individual patient characteristics, including age, sex, seizure type, and financial circumstance.

控制癲癇發作可使用的藥物超過十二種以上,決定藥物使用的先後順序是依據各個病人狀況而有所不同,包括:年齡、性別、癲癇發作型態與財務狀況。

The new research is among the first to examine long-term outcomes in newly diagnosed patients, says researcher Patrick Kwan, MD, PhD, of Australia's University of Melbourne.

最新研究是針對新診斷出的癲癇患者,追蹤長期的癲癇控制效果。澳洲墨爾本Patrick Kwan教授表示。

The study included about 1,100 epilepsy patients in Scotland and followed them from their first drug treatment for as few as two years and as many as 26 years.

Patients were considered seizure-free if they had no seizures for at least a year without changing their drug regimen.

研究蘇格蘭的1,100癲癇患者,追蹤藥物控制從2年到最長26年。如果在沒有變動療程的一年內,癲癇都不再發作,則病患有可能從此不再是癲癇患者。

If seizures continued, a second drug was given, either alone or in combination with the first. And if seizures still were not controlled, different drugs or drug combinations were tried, with some receiving up to nine different drug regimens.

當發作持續,就開始使用第二種藥物,結合第一種藥物或單獨服用因人而異。如果發作仍舊無法控制,就試著使用不同藥物或加入不同的藥物組合,有些患者持續使用九種的藥物療程。

1 in 4 Patients Never Seizure-Free ( 25%的患者,仍持續發作 )

Among the major findings: 研究發現

  • 50% of patients were seizure free on the first drug they tried and an additional 13% were seizure free after trying a second drug.

50%患者使用第一顆藥物,發作即獲得控制。其餘的13%患者,使用第二種藥物,發作獲得控制。

  • 37% of patients became seizure-free within six months of starting treatment, and an additional 22% became seizure-free after more than six months.

37%患者,在開始使用藥物治療的六個月內,癲癇停止發作。其餘22%患者,在六個月後發作停止。

  • 1 in 4 patients were never free of seizures for a complete year during the study period.

25%患者,在一年後,仍有癲癇發作情況。

The study appears online ahead of publication in the May 15 issue of the journalNeurology.

這項研究在515號的神經學刊公開發表。

In an accompanying editorial, Penovich and neurologist Michael Gruenthal, MD, PhD, of the Albany Medical Center in New York, write that the new research identifies important patterns of treatment response.

神經學專家PenovichMichael 博士,對於控制癲癇發作的重要因素皆有新研究發現。

They conclude that failure of two drug regimens in patients who take their medications as directed strongly predicts poor response to future drug therapies.

研究發現,當患者對兩種以上藥物的反應不好時,即使未來在使用藥物治療,效果也會比預期來的低。

"We interpret this as compelling evidence that patients who do not respond to two regimens should be offered additional evaluations to verify the diagnosis of epilepsy and identify potential opportunities for surgical treatment," they write.

經由這次研究,可以推論,當患者對兩種藥物沒有反應時,應該給予其他的輔助治療方法,或者考慮其他的開刀治療可能性。

arrow
arrow
    全站熱搜

    多發癲癇兒分享世 發表在 痞客邦 留言(0) 人氣()