| Purpose: Levetiracetam(LEV) is a new anti-epileptic drug(AED)with efficacy in patients with partial onset epilepsy. However,results from these highly controlled short-term clinical trials cannot simply be extrapolated to everyday clinical practice. So our purpose is to study the efficacy, safety and retention rate of LEV in Chinese epilepsy patients treated in out-patient epilepsy centre of in Chongqing, a west city of China.Patients and methods: We followed up 134 patients treated with LEV between June 2007 to July 2009. We accessed to their medical accords and called their caregivers to obtain the data necessary to analysis. The efficacy was assessed according to the percentage of responders (decreased seizure frequency≥50%) and seizure free patients every 3 months up to 21 months after LEV treatment on the basis of intention-to treat analysis. We also evaluated the efficacy of LEV monotherapy and rapid onset of LEV treatment. Then we analyzed the safety, retention rate and reasons of discontinuation.Results: The percentage of responders and seizure-free patients was high and stable in each 3 months assessment interval. Logistic regression model performed at each assessment point did not reveal any statistically significance correlations between responders and other parameters. 22.4% patients appeared possibly LEV related adverse events. Retention rate was 51.8%, 37.0% and 30.5% respectively after 6, 12 and 21 months. Seizure frequency before LEV treatment, reasons for starting LEV and with LEV monotherapy affected retention rate according to Cox proportional hazards regression model. The main reasons of discontinuation included inadequate efficacy alone in 44.7% and affordability alone in 40%.Conclusions: Our study shows that LEV treatment (included monotherapy) is effective, safe and rapid onset for all types of seizures, with lower retention rate in China, which may be related to its high costs. And new ongoing placebo-controlled studies are needed further clarify our results. |
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