Abstracts

Topiramate (TPM) has been evaluated in several double-blind, randomized, controlled trials of epilepsy in children as young as 2 years of age; studies in infants are currently underway. The dosages of TPM as adjunctive therapy that are currently being evaluated in infants were based, in part, on findings from a survey of neurologists and epileptologists with personal experience in using TPM in infants., A random sample of neurologists and epileptologists participated in an online survey of TPM dosing practices in infants. A total of 101 physicians met eligibility requirements and completed the survey. The majority (69%) had treated at least 50 infants with epilepsy (mean, 198) during the last 3 years. The majority (94%) also had experience in using TPM in infants; about 1 in 5 (19%) of all infants had been treated with TPM. The survey consisted of 19 questions concerning initial dose when starting infants on TPM; weekly rate of TPM dose increase; maximum TPM dose for infants; typical TPM maintenance dose; and use of blood levels for adjusting TPM therapy., Physicians in this survey generally agreed on [le]3.0 mg/kg/day TPM as a starting dose for infants and on [le]3.0 mg/kg/day as a titration increment. However, maintenance doses, maximum doses, and target blood levels varied widely. Although most physicians (88%) used maintenance doses of [le]15 mg/kg/day, 3% used maintenance doses of 25-50 mg/kg/day; 9% used maximum doses of 40-60 mg/kg/day., Further studies are underway to define weight-based TPM dosages for infants, which may vary according to age/development. These systematic evaluations of pharmacokinetics and efficacy across a wide range of TPM dosages in infants with epilepsy will close a critical gap in information available to clinicians using TPM to treat epilepsy in children., (Supported by Johnson [amp] Johnson Pharmaceutical Research [amp] Development, LLC.)