Abstracts

Of new-generation antiepileptic drugs (AED), three agents: oxcarbazepine, topiramate and lamotrigine are recommended by AAN and AES for monotherapy in drug-resistant epilepsy with partial seizures. If, however, addition of a new-generation AED to current therapy leads to a considerable improvement, an add-on monotherapy may be attempted. The aim of this study was to determine the possibility of transition to new-generation AED monotherapy in drug-resistant epilepsy with partial seizures. The trial was carried out in 898 patients with drug-resistant epilepsy with partial seizures, who had previously been treated with three AED at the maximum and had one new-generation agent added on as the first attempt: oxcarbazepine (n=152), tiagabine (n=136), vigabatrin (n=125), topiramate (n=162), lamotrigine (n=170) or gabapentin (n=153). Polytherapy reduction and transition to new-generation AED monotherapy included responders achieving at least 50% seizure number reduction. New-generation AED doses were increased according to clinical requirements. Therapeutic efficacy was assessed using the R ratio coefficient and safety - by adverse effect questionnaire. Of 898 patients, 282 (31.4%) were excluded due to treatment inefficiency and/or adverse effects. Of the remaining 616 patients, polytherapy reduction was achieved in 423, and transition to monotherapy - in 292 (47.4%). No significant differences between particular drugs or in monotherapy efficacy were noted. The mean number of adverse effects dropped from 4.3 in polytherapy to 1.8 in monotherapy. Transition to new-generation AED monotherapy is possible in almost 50% of patients with drug-resistant epilepsy with partial seizures, in whom add-on therapy using the AED is effective, regardless of the type of agent employed. Transition to monotherapy results in a considerable drop in the number of adverse effects.