Abstracts

Rationale: Rational polytherapy is often utilized, but limited evidence regarding its efficacy is available. We identified potentially effective drug combinations in patients receiving 2-drug AED treatment. Methods: We performed a retrospective analysis of 5171 entries in the UAB epilepsy center database. Duplicate patients were eliminated. Patients had to be on 2-drug combinations of AED. Patients were excluded if they were not seizure free on an AED combination. For each drug, a mean percent seizure free rate was determined across all combinations. Combinations with seizure free rates >1.5 SD above the mean were considered to be potentially beneficial, and combinations >1.5 SD below the mean were considered to be potentially ineffective. Combinations with <10 patients were eliminated from the final analysis. Results: A total of 1328 patient records were evaluated with 379 patients being identified as seizure free on a drug combination. Preliminary analysis indicates that PHT-PB and CBZ-VPA were potentially beneficial. A potentially ineffective combination was PHT-TPM. For men, CBZ-VPA was possibly effective compared to PHT-PB and VPA-LEV for women. Possible ineffective combinations were PHT-TPM for men and LTG-ZNS for women. For whites, possible effective combinations were PHT-LTG and CBZ-GBP and an ineffective combination was LEV-OXC compared to CBZ-VPA as an ineffective combination for non-whites. Patients with IGE or JME were also evaluated independently and potentially effective combinations included LEV-PB and LTG-FBM. A possible ineffective combination for IGE and JME was PHT-VPA. Conclusions: Potentially beneficial and ineffective 2-drug combinations of AED were identified. Differences in responses based on race and gender were also observed.