Resistance to valproic acid as predictor of treatment resistance in genetic generalized epilepsies

Joanna Gesche, Marina Khanevski, Carl Solberg, Christoph Patrick Beier

Research output: Contribution to journalLetterResearchpeer-review

Abstract

This study aimed at defining clinical predictors of drug resistance in adults with genetic generalized epilepsy (GGE) who were treated with a broad spectrum of antiepileptic drugs. Of a cohort of 137 unselected adult GGE patients with long-term follow up, clinical and demographic data, putative prognostic factors (e.g., psychiatric comorbidities, electroencephalography [EEG]), treatment response, and data indicative of social status were collected. Fifty-eight patients had seizures within the past year. Thirty-three patients met the definition of "drug-resistant epilepsy" according to the International League Against Epilepsy (ILAE) definition. Psychiatric comorbidities, age at first diagnosis, and absences were associated with worse seizure control, whereas focal changes in EEG remained without prognostic impact. Resistance to valproic acid was the most important prognostic factor for refractory seizures. Resistance to valproic acid had a specificity of 100% to identify patients with drug resistance and correlated strongly with bad social outcome and seizure burden. Conversely, 21.2% of all patients with refractory seizures according to the ILAE definition later became seizure free (mainly with valproic acid). Our data suggest that "drug resistant GGE" must not be declared unless patients were adequately treated with valproic acid, and advocate resistance to valproic acid as a new clinical biomarker for drug-resistant GGE. A PowerPoint slide summarizing this article is available for download in the Supporting Information section here.

Original languageEnglish
JournalEpilepsia
Volume58
Issue number4
Pages (from-to)e64-e69
ISSN0013-9580
DOIs
Publication statusPublished - 1. Apr 2017

Fingerprint

Valproic Acid
Drug Resistance
Comorbidity
Electroencephalography
Pharmaceutical Preparations

Keywords

  • Drug resistance
  • Genetic generalized epilepsy
  • Juvenile absence epilepsy
  • Juvenile myoclonic epilepsy
  • Valproic acid

Cite this

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title = "Resistance to valproic acid as predictor of treatment resistance in genetic generalized epilepsies",
abstract = "This study aimed at defining clinical predictors of drug resistance in adults with genetic generalized epilepsy (GGE) who were treated with a broad spectrum of antiepileptic drugs. Of a cohort of 137 unselected adult GGE patients with long-term follow up, clinical and demographic data, putative prognostic factors (e.g., psychiatric comorbidities, electroencephalography [EEG]), treatment response, and data indicative of social status were collected. Fifty-eight patients had seizures within the past year. Thirty-three patients met the definition of {"}drug-resistant epilepsy{"} according to the International League Against Epilepsy (ILAE) definition. Psychiatric comorbidities, age at first diagnosis, and absences were associated with worse seizure control, whereas focal changes in EEG remained without prognostic impact. Resistance to valproic acid was the most important prognostic factor for refractory seizures. Resistance to valproic acid had a specificity of 100{\%} to identify patients with drug resistance and correlated strongly with bad social outcome and seizure burden. Conversely, 21.2{\%} of all patients with refractory seizures according to the ILAE definition later became seizure free (mainly with valproic acid). Our data suggest that {"}drug resistant GGE{"} must not be declared unless patients were adequately treated with valproic acid, and advocate resistance to valproic acid as a new clinical biomarker for drug-resistant GGE. A PowerPoint slide summarizing this article is available for download in the Supporting Information section here.",
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Resistance to valproic acid as predictor of treatment resistance in genetic generalized epilepsies. / Gesche, Joanna; Khanevski, Marina; Solberg, Carl; Beier, Christoph Patrick.

In: Epilepsia, Vol. 58, No. 4, 01.04.2017, p. e64-e69.

Research output: Contribution to journalLetterResearchpeer-review

TY - JOUR

T1 - Resistance to valproic acid as predictor of treatment resistance in genetic generalized epilepsies

AU - Gesche, Joanna

AU - Khanevski, Marina

AU - Solberg, Carl

AU - Beier, Christoph Patrick

N1 - Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

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