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Long-Term Following-Up of Topiramate Treatment on Infants with Epilepsy

GUO Ya-le,HUANG Shao-ping,YANG Lin,ZHOU Jian-ping,LI Dan(Department of Pediatrics,the Second Affiliated Hospital of Xi′an Jiaotong University Medical School,Xi′an 710004,Shanxi Province,China)  
Objective To evaluate long-term efficacy and safety of topiramate(TPM)as monotherapy in infants with various types of epilepsy.Methods One hundred and thirty-one infants,aged lower 2 years,with various types of epilepsy were underwent open-label experience with topiramate table as monotherapy:117 infants recepted TPM began as 0.5-1.0 mg/(kg·d),their dose had been added 0.5-1.0 mg/(kg·d) every 1-2 weeks until they got to the subject doses or the most endurece doses,14 infants with often seizures recepted the rapid dose adding,their TPM doses had been added 0.5-1.0 mg/(kg·d) every 2-3 days.The ratio of effective and seizure free were assessed after 1 to 7 years;the curative effects of TPM,the reason for which TPM therapy had been stopped or translated to other drugs or added by other drugs,and the side effects were also evaluated during open-label treatment period.Results 1.The period from the first attach to TPM therapy had been accepted were 1.0 day to 1.5 year,mean was 3 months,children were 1.5-9.0 years old when the last follow-up time,there were 51.15% of the patients being still taking TPM as monotherapy at last in this follow-up study,there were 4.58% of the patients had stopped their therapy.2.There were 73 children active to TPM ate monotherapy in 131 children in this investigation,the effective rate was 55.73%,there were 64 children had no attach,the seizure free rate was 48.85%;the effective rate was 58.33%,and the seizure free rate was 51.05% in generalized seizure,those in local seizures were 51.52% and 45.45%.The optinal dosage in effective patients was(2.85±1.31) mg/(kg·d),the dosage in uneffective children was(4.27±2.08) mg/(kg·d),there was significance different between them(P0.01).3.The effective rate(seizure-free rate) in 1,3,5,7 years later were 60.47%(51.94%),59.60%(52.53%),55.0%(47.50%),68.42%(47.37%).4.Side effects were observed in 10.68% of 131 cases of epilepsy,the side effects included no sweat and fever,no appetite,lose of weight,disphoria as well as somnipathy.Conclusion TPM is a widespread antiepileptic drug with high efficacy and safety for long-term ate as monotherapy administration in infants with various types of epilepsy.
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