Abstracts

Rationale: To explore effectiveness and tolerability outcomes of hospitalized patients with epileptic seizures treated with topiramate (TPM) Methods: Prospective, open label, single arm, observational study including hospitalized patients >= 12 yrs with epilepsy. Patients were evaluated during their hospitalization (visits V1-V3) and during an optional follow up visit (phone or office visit about 12 weeks after V3). Seizure frequency during a 4 week retrospective baseline and prospective hospital course and optional follow up visit, adverse events (AEs) and the evaluation of therapy by physician and patients were documented.Results: 154 patients (53% male; mean age 61 yrs +/- 19) were selected. 84% were treatment naïve, 16% had at least one AED before baseline. 5% of patients discontinued therapy during their hospitalization due to AEs (3%) or transition to a different AED (3%; multiple answers possible). 81% with data from V4 continued on TPM, 11% were switched to another AED, in 6% anticonvulsant therapy was discontinued. 57% of patients were >=60. Mean age in treatment naïve patients was higher than in pretreated patients (63 yrs vs 50 yrs, p<0.002). Therapy naïve patients were older at first diagnosis and epilepsy duration was shorter (p<0.0001). 66% were diagnosed with partial, 22% with primary generalized epilepsy. Reasons for hospitalization were acute epileptic seizures (73%), diagnostic workup (29%), treatment initiation of TPM (8%). Reasons to initiate TPM as AED were comorbidities (66%), concomitant medication (42%) or advanced age (39%) of the patient. Initial median dose of TPM was 25mg/day and at V3 (median 6 days) 50mg/day (range, 25mg - 150mg). In patients with V4 (median 103 days) median maximum daily dose was 75mg/day. Seizure frequency decreased from 11 +/- 70 / 4 weeks during the retrospective baseline to 3 +/- 11 (p<0.001) at endpoint (V3). 82% were seizure free during the hospitalisation. Taking only patients with the optional follow up visit (V4, N=86 with seizure documentation) into account, seizure frequency decreased from 15 +/- 92 to 1 +/- 7 at endpoint (p<0.0001). A total of 63 TEAE were reported and 58 were considered as treatment related; 25 occurred during hospital stay (V1-V3) and 33 after V3. AE occurring in >