Abstracts

Rationale: Information regarding the use of a newly approved antiepileptic drug (AED) in a clinical practice setting compared to a clinical research setting is valuable. Using the Postmarketing Antiepileptic Drug/Device Survey (PADS) database, we sought to evaluate the patient population selected and the titration schedule used when initiating oxcarbazepine(OXC). Methods: The PADS database contains information from 16 epilepsy centers on all patients starting newly marketed AEDs and the VNS. The subjects are enrolled prospectively and clinical care is not altered by the study. Demographic information, past neurologic history, and response to the new treatment is gathered for subsequent analysis. Results: Since the release of OXC, 65 patients started on OXC were enrolled in the PADS database, having a mean age of 37 years (range 8-71) and mean age of onset of epilepsy of 15 years (range 1-61); 34 were female. Five patients were started on monotherapy, 27 were on 1 concurrent AED, 24 took 2 AEDs, 8 took 3 AEDs, 1 took 4 AEDs. Frequently used concurrent AEDs were 33 CBZ, 17 LTG, 16 PHT, 13 TPM, 11 GBP, and 10 VPA. The mean number of previously failed AEDs was 3.78 (range 0-10). Ten patients (15%) had not clearly failed any previous AEDs. No patients had a history of CBZ rash. Fifty patients had partial seizure disorders, 6 had primary generalized epilepsy, 2 had Lennox-Gastaut, 1 had Rasmussen's syndrome and 6 were syndromically unclassified. 12 patients (18%) were directly switched from CBZ to OXC without titration. Twenty-five patients were to be titrated at 300 mg/week and 25 at 600mg/week. Titration was unspecified in 3 patients. Conclusion: Although OXC is generally being used in a refractory population of partial epilepsy patients, it is also being tried earlier in treatment and as monotherapy in a significant fraction of epilepsy patients. Additionally, many patients were directly switched from CBZ. Further analysis will include outcome in terms of safety, tolerability and effectiveness.