Abstracts

RATIONALE: This study examines the ability of adjunctive lamotrigine (LTG) treatment to improve economic outcomes related to work, leisure, and health care utilization in patients with refractory epilepsy. METHODS: Data were collected as part of the Adjunctive Lamictal in Epilepsy: Response to Treatment (ALERT) study, an open-label trial of the safety of adding LTG to current antiepileptic drug regimens in 637 patients with refractory epilepsy. Economic outcome measures (i.e., number of work days missed, seizures at work, leisure activities missed, doctor office visits, emergency room visits, hospital admissions, and days hospitalized over the past two months) at week 16 were compared with baseline values. Statistical evaluations utilized Wilcoxon signed rank test. A separate analysis comparing patients who discontinued LTG with patients on LTG at week 16 was also conducted in order to evaluate potential sample bias in the within-subject comparison. RESULTS: At baseline, there were no statistically significant differences in their demographic characteristics and epilepsy severity between the group completing the study (n=555; 87%) and those who discontinued LTG (n=82; 13%). At week 16, however, those who completed the study had significant reductions compared with baseline in work days missed (p<0.001), seizures at work (p=0.005), leisure activities missed (p=0.026), doctor visits (p<0.001), emergency room visits (p<0.001) and hospital admissions (p=0.027), but not in days hospitalized. CONCLUSIONS: Results from this prospective observational study expand findings from prior published literature. LTG therapy improves economic outcomes related to work, leisure, and health care utilization in patients with refractory epilepsy.