Population-based natural history of epilepsy in South Korea: A seven-year retrospective cohort study
Abstract number :
3.47
Submission category :
16. Epidemiology
Year :
2022
Submission ID :
2232874
Source :
www.aesnet.org
Presentation date :
12/5/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:28 AM
Authors :
Yongmoo Kim, MD – Seoul National University Hospital; Yoonhyuk Jang, MD. – Seoul National University Hospital; Han Sang Lee, MD. – Seoul National University Hospital; Ki-Young Jung, MD. PhD. – Seoul National University Hospital; Soon-Tae Lee, MD. PhD. – Seoul National University Hospital; Kyung-Il Park, MD. PhD. – Seoul National University Hospital Healthcare system Gangnam center; Sang Kun Lee, MD. PhD. – Seoul National University Hospital
This is a Late Breaking abstract
Rationale: Epidemiologic studies of epilepsy have been conducted in various countries, but most of them were cross-sectional, and even for longitudinal cohorts, a restrictive number of epilepsy patients up to thousands have been studied. This study aimed to explore the natural history of patients with epilepsy using overall antiseizure-medication (ASM) treatment patterns on a nationwide scale in South Korea.
Methods: We investigated a retrospective longitudinal cohort of patients with epilepsy in South Korea using nationwide data from the Korean National Health Information Database of the Health Insurance and Review Assessment Service between January 1, 2009, and December 31, 2018. Histories of each patient's ASM prescription were followed for up to 7 years from the index date, the first observed date of ICD-10 epilepsy diagnosis codes with at least one ASM prescription.
Results: Of 82,390 incident patients, ten thousand and fifty-nine were followed up to seven years, and nearly 60% of them discontinued the ASM(s). The proportion of patients with drug-resistant epilepsy (DRE), who experience three or more types of ASMs gradually increased, reaching approximately 8.8% of the total number of patients in the seventh year (6.45% for adults, 21.8% for children). The duration of progression for half of the patients with DRE was 1.29 years for children, 1.79 years for adults, and 1.62 years for mixed-age patients. However, even in the sixth year, 72 cases progressed to DRE, and 6 cases with DRE discontinued ASMs in the next year, showing a dynamic process.
Conclusions: Our population-based study showed that in reality, the overall prognosis for epilepsy patients may be better than previously known from hospital-based studies. The remission and progression of DRE were dynamic, confirming that individualized management is essential to treat epilepsy.
Funding: None
Epidemiology