Advances in screening models for identifying new antiepileptic drugs

2011 ◽  
pp. 22-36
Author(s):  
Kinga K Borowicz ◽  
Stanislaw J Czuczwar
Keyword(s):  
Antiepileptic Drugs ◽  
New Antiepileptic Drugs

scholarly journals Using routinely recorded data in a UK RCT: a comparison to standard prospective data collection methods

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
G. A. Powell ◽  
L. J. Bonnett ◽  
C. T. Smith ◽  
D. A. Hughes ◽  
P. R. Williamson ◽  
...  
Keyword(s):  
Case Report ◽  
Cost Effectiveness ◽  
Missing Data ◽  
Antiepileptic Drugs ◽  
Secondary Care ◽  
Significant Degree ◽  
New Antiepileptic Drugs ◽  
Optimal Mix ◽  
Recorded Data ◽  
Randomised Controlled

Abstract Background Routinely recorded data held in electronic health records can be used to inform the conduct of randomised controlled trials (RCTs). However, limitations with access and accuracy have been identified. Objective: Using epilepsy as an exemplar condition, we assessed the attributes and agreement of routinely recorded data compared to data collected using case report forms in a UK RCT assessing antiepileptic drug treatments for individuals newly diagnosed with epilepsy. Methods The case study RCT is the Standard and New Antiepileptic Drugs II (SANAD II) trial, a pragmatic, UK multicentre RCT assessing the clinical and cost-effectiveness of antiepileptic drugs as treatments for epilepsy. Ninety-eight of 470 eligible participants provided consent for access to routinely recorded secondary care data that were retrieved from NHS Digital Hospital Episode Statistics (N=71) and primary and secondary care data from The Secure Anonymised Information Linkage Databank (N=27). We assessed data items relevant to the identification of individuals eligible for inclusion in SANAD II, baseline and follow-up visits. The attributes of routinely recorded data were assessed including the degree of missing data. The agreement between routinely recorded data and data collected on case report forms in SANAD II was assessed using calculation of Cohen’s kappa for categorical data and construction of Bland-Altman plots for continuous data. Results There was a significant degree of missing data in the routine record for 15 of the 20 variables assessed, including all clinical variables. Agreement was poor for the majority of comparisons, including the assessments of seizure occurrence and adverse events. For example, only 23/62 (37%) participants had a date of first-ever seizure identified in routine datasets. Agreement was satisfactory for the date of prescription of antiepileptic drugs and episodes of healthcare resource use. Conclusions There are currently significant limitations preventing the use of routinely recorded data for participant identification and assessment of clinical outcomes in epilepsy, and potentially other chronic conditions. Further research is urgently required to assess the attributes, agreement, additional benefits, cost-effectiveness and ‘optimal mix’ of routinely recorded data compared to data collected using standard methods such as case report forms at clinic visits for people with epilepsy. Trial registration Standard and New Antiepileptic Drugs II (SANAD II (EudraCT No: 2012-001884-64, registered 05/09/2012; ISRCTN Number: ISRCTN30294119, registered 03/07/2012))

Overview of Lamotrigine and the New Antiepileptic Drugs: The Challenge

1997 ◽  
Vol 12 (1_suppl) ◽  
pp. S48-S52 ◽  
Author(s):  
John M. Pellock
Keyword(s):  
Adverse Effect ◽  
Adverse Effects ◽  
Antiepileptic Drugs ◽  
Adjunctive Therapy ◽  
Dose Titration ◽  
Childhood Epilepsy ◽  
Major Advance ◽  
New Antiepileptic Drugs ◽  
Life Threatening ◽  
Titration Schedule

Lamotrigine, like all antiepileptic drugs, can be effective when used as monotherapy or adjunctive therapy. In general, adverse effects are reduced when monotherapy is employed. The most frequent adverse effect prompting withdrawal of lamotrigine is rash. This potentially life-threatening adverse effect occurs more frequently in children, is increased when a rapid dose titration schedule is employed, and is greater when lamotrigine is prescribed in combination with valproate. The availability of lamotrigine and other antiepileptic drugs represents a major advance for the treatment of childhood epilepsy. The challenge in using all of the new antiepileptic drugs, including lamotrigine, is to balance the expected improved efficacy with the potentially serious adverse effects. (J Child Neurol 1997;12(Suppl 1):S48-S52).

Conventional and New Antiepileptic Drugs on Vitamin D and Bone Health: What We Know to Date?

2016 ◽  
Vol 11 (1) ◽  
pp. 69-70 ◽  
Author(s):  
Antonio Siniscalchi ◽  
Giovambattista De Sarro ◽  
Andzelika Michniewicz ◽  
Luca Gallelli
Keyword(s):  
Vitamin D ◽  
Antiepileptic Drugs ◽  
Bone Health ◽  
New Antiepileptic Drugs

Drug treatment of epilepsy: From serendipitous discovery to evolutionary mechanisms

2021 ◽  
Vol 28 ◽  
Author(s):  
Shengying Lou ◽  
Sunliang Cui
Keyword(s):  
Drug Treatment ◽  
Antiepileptic Drugs ◽  
Brain Disorder ◽  
Evolutionary Mechanisms ◽  
Main Method ◽  
New Era ◽  
Treatment Of Epilepsy ◽  
New Antiepileptic Drugs ◽  
Novel Drugs ◽  
Voltage Gated Ion Channels

: Epilepsy is a chronic brain disorder caused by abnormal firing of neurons. Up to now, using antiepileptic drugs is the main method of epilepsy treatment. The development of antiepileptic drugs lasted for centuries. In general, most agents entering clinical practice act on the balance mechanisms of brain “excitability-inhibition”. More specifically, they target voltage-gated ion channels, GABAergic transmission and glutamatergic transmission. In recent years, some novel drugs representing new mechanisms of action have been discovered. Although there are about 30 available drugs in the market, it is still in urgent need of discovering more effective and safer drugs. The development of new antiepileptic drugs is into a new era: from serendipitous discovery to evolutionary mechanism-based design. This article presents an overview of drug treatment of epilepsy, including a series of traditional and novel drugs.

Mechanisms of Action of New Antiepileptic Drugs

Epilepsia ◽  
1989 ◽  
Vol 30 (s1) ◽  
pp. S29-S34 ◽  
Author(s):  
Roger J. Porter
Keyword(s):  
Antiepileptic Drugs ◽  
Mechanisms Of Action ◽  
New Antiepileptic Drugs
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