Abstracts

Rationale: There has been a great surge of new antiepileptic drugs (AEDs) for treatment of epilepsy. Limited data exist on pharmacokinetics and pharmacogenomics of new AEDs in Korea. The aim of this study is to establish the therapeutic index of new AEDs, which are prescribed commonly in Korea, using a hospital-based, prospective registry with a computerized database.Methods: The Seoul National University Hospital Epilepsy Registry (SNUHER) study has registered patients (18-80 years of age) with epilepsy, which was confirmed by clinical symptoms, electroencephalography, and brain imaging studies. The patient record consists of demographic factors, clinical features, diagnosis, treatment, and clinical outcome. We also have obtained data of serum concentrations of current AEDs, polymorphism profile, and drug response. In this study, we focused on the patients who have been taking new AED monotherapy or combination therapy including new AEDs. New AEDs included pregabalin, lamotrigine, levetiracetam, oxcarbazepine, and topiramate. The serum concentrations of new AEDs were measured by liquid chromatography-tandem mass spectrometry.Results: Of patients registered in the SNUHER between February 2011 and June 2011, 390 patients were eligible for this study. The ranges of serum concentration for each new AED were as followings: topiramate, 23.1~16,200.0 ng/L (n=128); lamotrigine; 165.5~15,080 ng/L (n=109); oxcarbazepine 50.2~4,512.0 ng/L (n=154); mono-hydroxy derivative of oxcarbazepine, 362.8~47,790 ng/L (n=163); levetiracetam 362.8~42,820 ng/L (n=140); and pregabalin 455.1~7,712 ng/L (n=46). Detailed clinical parameters and correlation studies are presented in the following conference.Conclusions: This prospective hospital-based registry would allow us to develop the basis of therapeutic index and guidelines for individualized AED therapy.