The Comparative Assessment Of AEDs Related To SUDEP

Part I:An attribution analysis of the correlation study on antiepileptic drugs with SUDEPObjective:To study a comparative risk assessment of polytherapy of AEDs and carbamzapine on sudden un death epilepsy and provide scientific evidence for rational use of antiepileptic drugs and prevent SUDEP. Methods:"SUDEP", and "Antiepileptic Drugs", "epileptic sudden death" as key words, search January 1,1960 to February 28,2011 MEDLINE and the Chinese Biomedical Literature Database published literature, the software application STATA11.0 of literature was applied on various aspects of epilepsy drugs calculated population attributable score (population attributable fractions, PAF).Results:The results included in this antiepileptic drugs and SUDEP on the analysis of the literature related to a total of five, all are case-control study,including multi-drug combination therapy on AEDs literature 5, carbamazepine therapy literature 3, adjusting the frequency of anti-epileptic drugs, phenytoin, sodium valproate therapy literature a combined relative risk (OR) values and 95% confidence interval (95% CI) were:AEDs multi-drug combination therapy 2.78 (2.10-3.67.04), each dose of anti-epileptic drugs are not frequently adjusted 0.67 (0.29-1.48), frequent adjustment of antiepileptic drug doses per year 5.90 (1.88-19.39), Application carbamazepine 1.88 (1.40-2.54), phenytoin application of 3.12 (1.38-7.22). All of which involve polytherapy of AEDs and carbamzapine PAF value were calcaulated, PAF value and 95%confidence interval (95%CI)for the polytherapy of AEDs 3.2%(1.87-5.31),carbamazepin treatment 9%(1.02-4.37). Conclusion:The application of polytherapy of AEDs and carbamzapine are SUDEP risk factors. Besides, the risk occurrence of polytherapy of AEDs on SUDEP compared with higher risk than occurrence of carbamazepine on SUDEP. We nedd to be vigilant attention and the occurrence of SUDEP in the clinical work. Partâ…¡:A meta-analysis of the risk factors related to polytherapy of antiepileptic drugs and carbamzepine on sudden unexpected death in epilepsyObjective:To study the risk factors related to polytherapy antiepileptic drugs and carbamzapine on sudden unexpected death epilepsy and provide scientific evidence for rational use of antiepileptic drugs and prevent SUDEP. Methods:The database of MEDLINE and CBM were searched and literature domestically and internationally from January 1,960 to February 28,2011 were collected using the search terms "SUDEP" and "Antiepileptic drugs". According to the first part of study conclusion:AEDs multi-drug combination therapy and carbamazepine pharmaceutical application is the application of AEDs on risk factors of SUDEP. The STATA11.0 software was used for meta analysis, and heterogeneity test I2 heterogeneity test based on application of fixed effects models, respectively, and the random effects model Meta-analysis of research results. Results:Meta analysis of the results included in anti-epileptic drugs on the literature associated with SUDEP total of five, all case-control studies, five literatures were multi-drug combination therapy AEDs associated with SUDEP research, but only three articles carbamazepine were associated with SUDEP research. SUDEP occurs with AEDs combined application of the risk factors associated with relative risk (OR) values and 95% confidence interval (95% CI) were:AEDs multi-drug combination therapy 3.02 (2.26-4.04), carbamazepine application of 2.02 (1.35-3.00), P values were <0.01. Conclusion:The multi-drug combination therapy and the AEDs carbamazepine treatment and the occurrence of SUDEP have significant correlation, and clinical application of multi-drug combination treatment of epilepsy, AEDs and carbamazepine should be alert to the occurrence of SUDEP.