Comparison Of Therapeutic Effects Of Lamotrigine On Pediatric Epilepsy In Patients From Both Rural And Urban China

Objective: To compare therapeutic effects of lamotrigine on pediatricepilepsy in patients from both rural and urban China.Methods:1. Using the method of prospective study, we studied patientswith different types of epilepsy receiving lamotrigine. The patients wererecruited from Children’s Hospital of Chongqing Medical University scinceJune2012to June2013.2. Patients were devided into two groupsaccording to whether they resided in rural or urban area, namedrespectively as group rural and group urban. And then group rural wasfurther devided into three subgroups according to transportation andlocation, named as group commom village, group remote village and groupvillage-in-city. Each group received lamotrigine in monotherapy orcombined therapy in accordance with their condition.3. Patients weremonitored closely for6months for seizure frequency, adverse effects andcompliance.4. Accomplish the data analysis.Results:1. Among the total of43cases in group rural, lamotrigine could achieve complete seizure control in13cases(30.2%)，and was significantlyeffective in5cases(11.6%), effective in14cases(32.6%). The totaleffective rate was74.4%. For group urban, One patient quited. Among thetotal of53cases left, lamotrigine could achieve complete seizure control in20eases(37.8%), and was significantly effective in16cases(30.2%),effective in8cases(15.1%). The total effective rate was83.0%. Thedifference was statistically significant(P<0.05).2. Among the total of11cases in group village-in-city, lamotrigine could achieve complete seizurecontrol in6cases(54.5%), and was significantly effective in3cases(27.3%),effective in1cases(9.1%). The total effective rate was90.9%. For groupcommom village, there were27patients. And lamotrigine could achievecomplete seizure control in5cases(18.5%)，and was significantly effectivein2cases(7.4%), effective in12cases(44.4%). The total effective rate was70.4%. The difference was statistically significant(P<0.05).3.Incomparison with group urban, group commom village was inferior to groupurban, with the difference being significantly different(P<0.01).4. In grouprural, patients whose caretakers’ education background was high schoolshowed a better effecacy than those with caretakers’ education backgroundbeing primary school(P<0.05). In group urban, patients under the care ofpeople with an education background of high school showed a bettereffecacy than those of primary school (P<0.05). And patients under the careof people with an education background of college showed a significantly better effecacy than those of primary school (P<0.01).5. For group ruraland group urban, patients from Chongqing and Sichuan showed nodifference with each other on effecacy(P>0.05).6.6(14.0%) patientsexperienced side effects in group rural, and for group urban the numberwas10(18.5%). Rash was the major side effect, because of which onequited due to being admitted into hospital. Other side effects weredrowsiness, dizziness, headache, liver function disturbance, anorexia andnausea. All adverse effects were mild in degree. There was no differencebetween two groups (P>0.05).7.18.6%patients in group rural showedunsatisfied compliance of taking medicine, manifesting as missing a dose,unauthorized reduction of dose and drug withdrawal. While for groupurban the ratio is15.1%. Indifference to taking medicine, lack of medicine,forgetfullness, worrying about side effects, improvement of the disease andeconomic hardship consisted of the main reasons for unsatisfiedcompliance of taking medicine. There was no difference between twogroups (P>0.05).Conclusion:1. Group urban is superior to group rural in terms oftherapeutic effects of lamotrigine.2. Group village-in-city is superior togroup commom village.3.Group common villege is significantly inferior togroup rural.4. There is a correlation between caregivers’ educationbackground and therapeutic effects to a certain degree. And patients underthe care of people with higher education background seem to have better therapeutic effects.5. Native place may have no effect on therapeuticeffects.6. Lamotrigine is well-tolerated in both group rural and groupurban.7. Both group rural and group urban show satisfied compliance oftaking medicine.8. Caretakers’ education background and transportationare the two factors affecting lamotrigine’ s effect on seizure control in ruralareas. However more work is needed to see whether and how potentialfactors work on therapeutic effects.