Abstracts

To assess seizure reduction and adverse events in different age groups of elderly patients ([underline][gt][/underline] 60) with epilepsy treated with topiramate (TOPAMAX, TPM)., In this prospective, open label, multicenter phase IV flexible dose study, elderly patients [[lt]65, 65 - 74 and [underline][gt][/underline]75 years (yrs)] with epilepsy irrespective of seizure type were included and followed for 12 months. Seizure frequency and adverse events were documented at each visit., 107 patients (53% male, mean age 69[plusmn]7 years) were enrolled, 32 patients [lt] 65yrs, 54 patients between 65yrs - 74yrs and 21 patients [gt] 74 yrs. 102 patients had at least one seizure during the retrospective baseline encompassing a 3 months period. Mean duration of epilepsy was 9.5 yrs. Most frequent seizure types at baseline were generalized tonic-clonic (58%) and complex partial (25%). Mean seizure frequency was 3.5[plusmn]14.6 and decreased to 1.6[plusmn]7.7 (p[lt]0.0001) versus baseline. At endpoint, the mean TPM dose was 98 mg/day in monotherapy and 153 mg/day in add-on. Mean dose was lowest (86 mg/day) and the percentage of monotherapy was highest in the oldest group. Overall, 78% of patients were responders (seizure reduction [ge]50%) and 44% remained seizure-free throughout the study. The highest percentage of responders was in the youngest group (96%).
46 patients (43%) had at least one treatment-emergent adverse event (TEAE). The number of TEAEs was highest amongst the oldest group. TEAEs [ge] 5% overall were somnolence (9.4%), dizziness (7.5%), paraesthesia (5.6%), and cognitive complaints (10.3%). Main reasons for study discontinuation (40% overall) were a TEAE (15.9%) or loss to follow-up (12.2%)., In elderly patients with epilepsy, TPM was well tolerated among all age groups andwas associated with a significant decrease in seizure frequency. Doses used were slightly lower than the recommended target doses for adults.,