RESEARCH ARTICLE

Prospective research on the efficacy and safety of oxcarbazepine as monotherapy and add-on therapy for partial epilepsy

  • Huicong KANG ,
  • Xiaoyan LIU ,
  • Hu QI ,
  • Feng XU ,
  • Xiang LI ,
  • Yuan WANG ,
  • Zhiguang LIU ,
  • Suiqiang ZHU
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  • Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China

Received date: 21 Nov 2008

Accepted date: 26 Dec 2008

Published date: 05 Jun 2009

Copyright

2014 Higher Education Press and Springer-Verlag Berlin Heidelberg

Abstract

The purpose of our research was to evaluate the efficacy, tolerance, and safety of oxcarbazepine (OXC) as monotherapy and add-on therapy for partial epilepsy. We carried out a prospective clinical follow-up trial at the Epilepsy Center of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology. Sixty-seven patients with partial epilepsy received OXC therapy. The patients were randomly divided into a monotherapy group and an add-on therapy group. We observed the efficacy and safety in the first three months and the following three months respectively, and compared them with each other. There was a significant difference in the decrease of seizure frequency between the two groups (P = 0.002). There was a significant difference in the percentage of seizure-free between the monotherapy and the add-on therapy groups in the first three months (P = 0.02), and there were also statistical differences in the 50% response rate (P = 0.017) and the percentage of seizure-free in the following three months (P = 0.019). No difference was found in the 50% response rate, the 75% response rate, and the percentage of seizure-free between the first three months and the following three months in the whole group and the two subgroups (P > 0.05). The incidence rate of side effects due to the therapy was 19.40% (13 of 67). The side effects were mainly found in the first three months. It is concluded that OXC is the first-line anti-epileptic drug (AED) for partial seizures, and could be used as the monotherapy and add-on therapy for newly diagnosed patients and patients that failed to tolerate or benefit from other AEDs.

Cite this article

Huicong KANG , Xiaoyan LIU , Hu QI , Feng XU , Xiang LI , Yuan WANG , Zhiguang LIU , Suiqiang ZHU . Prospective research on the efficacy and safety of oxcarbazepine as monotherapy and add-on therapy for partial epilepsy[J]. Frontiers of Medicine, 2009 , 3(2) : 181 -186 . DOI: 10.1007/s11684-009-0025-6

Acknowledgements

The study was supported by the National Natural Science Foundation of China (Grant No. 30770752).
1
GiustizieriM, ArmogidaM, BerrettaN, FedericiM, PiccirilliS, MercuriN B, NisticoR. Differential effect of carbamazepine and oxcarbazepine on excitatory synaptic transmission in rat hippocampus. Synapse, 2008, 62(10): 783-789

DOI

2
AmbrosioA F, Soares-Da-SilvaP, CarvalhoC M, CarvalhoA P. Mechanisms of action of carbamazepine and its derivatives, oxcarbazepine, BIA 2-093, and BIA 2-024. Neurochem Res, 2002, 27(1): 121-130

DOI

3
DoganE A, UstaB E, BilgenR, SenolY, AktekinB. Efficacy, tolerability, and side effects of oxcarbazepine monotherapy: a prospective study in adult and elderly patients with newly diagnosed partial epilepsy. Epilepsy Behav, 2008, 13(1): 156-161

DOI

4
GazzolaD M, BalcerL J, FrenchJ A. Seizure-free outcome in randomized add-on trials of the new antiepileptic drugs. Epilepsia, 2007, 48(7): 1303-1307

DOI

5
MarsonA G, AppletonR, BakerG A, ChadwickD W, DoughtyJ, EatonB, GambleC, JacobyA, ShackleyP, SmithD F, Tudur-SmithC, VanoliA, WilliamsonP R. A randomised controlled trial examining the longer-term outcomes of standard versus new antiepileptic drugs. The SANAD trial. Health Technol Assess, 2007, 11(37): iii-iv, ix-x, 1-134

6
HerranzJ L, ArgumosaA, Salas-PuigJ. Oxcarbazepine in monotherapy in 324 patients with partial seizures (TRINOVA study). Rev Neurol, 2004, 39(7): 601-606

7
FrenchJ A, KannerA M, BautistaJ, Abou-KhalilB, BrowneT, HardenC L, TheodoreW H, BazilC, SternJ, SchachterS C, BergenD, HirtzD, MontourisG D, NespecaM, GidalB, MarksW J Jr, TurkW R, FischerJ H, BourgeoisB, WilnerA, FaughtR E Jr, SachdeoR C, BeydounA, GlauserT A. Efficacy and tolerability of the new antiepileptic drugs, I: Treatment of new-onset epilepsy: report of the TTA and QSS Subcommittees of the American Academy of Neurology and the American Epilepsy Society. Epilepsia, 2004, 45(5): 401-409

8
FrenchJ A, KannerA M, BautistaJ, Abou-KhalilB, BrowneT, HardenC L, TheodoreW H, BazilC, SternJ, SchachterS C, BergenD, HirtzD, MontourisG D, NespecaM, GidalB, MarksW J Jr, TurkW R, FischerJ H, BourgeoisB, WilnerA, FaughtR E Jr, SachdeoR C, BeydounA, GlauserT A. Efficacy and tolerability of the new antiepileptic drugs, II: Treatment of refractory epilepsy: report of the TTA and QSS Subcommittees of the American Academy of Neurology and the American Epilepsy Society. Epilepsia, 2004, 45(5): 410-423

DOI

9
GlauserT, Ben-MenachemE, BourgeoisB, CnaanA, ChadwickD, GuerreiroC, KalviainenR, MattsonR, PeruccaE, TomsonT. ILAE treatment guidelines: Evidence-based analysis of antiepileptic drug efficacy and effectiveness as initial monotherapy for epileptic seizures and syndromes. Epilepsia, 2006, 47(7): 1094-1120

DOI

10
FreidelM, KrauseE, KuhnK, PeperR, VogelH. Oxcarbazepine in the treatment of epilepsy, 2007, 75(2): 100-106

11
PaulettoG, BergonziP; Triveneto Epilepsy Study Group. Oxcarbazepine reduces seizure frequency in a high proportion of patients with both newly diagnosed and refractory partial seizures in clinical practice. Seizure, 2006, 15(3): 150-155

DOI

12
BeydounA, SachdeoR C, KutluayE, McCagueK, D'SouzaJ. Sustained efficacy and long-term safety of oxcarbazepine: one-year open-label extension of a study in refractory partial epilepsy. Epilepsia, 2003, 44(9): 1160-1165

DOI

13
SchmidtD, ArroyoS, BaulacM, DamM, DulacO, FriisM L, KälviäinenR, KrämerG, van ParysJ, PedersenB, SachdeoR. Recommendations on the clinical use of oxcarbazepine in the treatment of epilepsy:a consensus view. Acta Neurol Scand, 2001, 104: 167-170

DOI

14
SchmidtD, SachdeoR. Oxcarbazepine for treatment of partial epilepsy: A review and recommendations for clinical use. Epilepsy Behav, 2000, 1(6): 396-405

DOI

15
FreidelM, KrauseE, KuhnK, PeperR, VogelH. Oxcarbazepine in the treatment of epilepsy. Fortschr Neurol Psychiatr, 2007, 75(2): 100-106

16
ZaccaraG, MessoriA, CincottaM, BurchiniG. Comparison of the efficacy and tolerability of new antiepileptic drugs: what can we learn from long-term studies? Acta Neurol Scand, 2006, 114(3): 157-168

DOI

17
FranzoniE, GaroneC, SarajlijaJ, GualandiS, MalaspinaE, CecconiI, MoscanoF C, MarchianiV. Open prospective study on oxcarbazepine in epilepsy in children: a preliminary report. Seizure, 2006, 15(5): 292-298

DOI

18
Novartis. Oxcarbazepine. Data on file, Basle, 1998

19
WilbyJ, KainthA, HawkinsN, EpsteinD, McIntoshH, McDaidC, MasonA, GolderS, O'MearaS, SculpherM, DrummondM, ForbesC. Clinical effectiveness, tolerability and cost-effectiveness of newer drugs for epilepsy in adults: a systematic review and economic evaluation. Health Technol Assess, 2005, 9(15): 1-157

20
AldenkampA P, De KromM, ReijsR. Newer antiepileptic drugs and cognitive issues. Epilepsia, 2003, 44(Suppl 4): 21-29

DOI

21
BeydounA, SachdeoR C, RosenfeldW E, KraussG L, SesslerN, MesenbrinkP, KramerL, D'SouzaJ. Oxcarbazepine monotherapy for partial-onset seizures: a multicenter, double-blind, clinical trial. Neurology, 2000, 54(12): 2245-2251

22
KraiprabP, ChinvarunY, TantisiraM H. Oxcarbazepine as add-on therapy in Thai epileptic patients with refractory partial seizures. J Med Assoc Thai, 2005, 88(Suppl 3): S193-201

23
PatsalosP N, BerryD J, BourgeoisB F, CloydJ C, GlauserT A, JohannessenS I, LeppikI E, TomsonT, PeruccaE. Antiepileptic drugs--best practice guidelines for therapeutic drug monitoring: a position paper by the subcommission on therapeutic drug monitoring, ILAE Commission on Therapeutic Strategies. Epilepsia, 2008, 49(7): 1239-1276

DOI

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