BACKGROUND It is widely agreed that carbamazepine and oxcarbazepine are highly effective in the long-term treatment of trigeminal neuralgia. However, the tolerability of these drugs across the different aetiologies of trigeminal neuralgia is still undetermined. METHODS In this retrospective, real-world study, we assessed the effectiveness and tolerability of carbamazepine and oxcarbazepine in a large cohort of patients with classical (254 patients), secondary (60 patients) and idiopathic (40 patients) trigeminal neuralgia. We analysed data using a propensity score analysis to account for selection bias; frequencies of side effects associated to carbamazepine and oxcarbazepine were calculated by adjusting data with the inverse probability of treatment weighting. RESULTS The initial proportion of responders was 88.3% with carbamazepine, and 90.9% with oxcarbazepine. The number of refractory patients was significantly higher in idiopathic (15%) and secondary forms (27%) than in classical trigeminal neuralgia (6%), (p<0.05). In 53 patients treated with carbamazepine (29.6%) and in 22 treated with oxcarbazepine (12.6%), major side effects caused treatment interruption or dosage reduction to an unsatisfactory level. Side effects occurred more frequently in patients treated with carbamazepine (43.6%) than with oxcarbazepine (30.3%, p<0.0001). The frequency of treatment discontinuation was higher in patients with secondary and idiopathic forms than in those with classical trigeminal neuralgia (p<0.05). CONCLUSIONS Our real-world study show that carbamazepine and oxcarbazepine are effective in most patients with trigeminal neuralgia; nevertheless, side effects are still a major issue, particularly in patients with secondary and idiopathic trigeminal neuralgia.

中文翻译：

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卡马西平和奥卡西平对 354 名三叉神经痛患者的真实疗效和耐受性

背景 人们普遍认为，卡马西平和奥卡西平在三叉神经痛的长期治疗中非常有效。然而，这些药物对三叉神经痛不同病因的耐受性仍未确定。方法 在这项回顾性的真实世界研究中，我们评估了卡马西平和奥卡西平在大量经典（254 名患者）、继发性（60 名患者）和特发性（40 名患者）三叉神经痛患者中的有效性和耐受性。我们使用倾向评分分析来分析数据以解释选择偏差；与卡马西平和奥卡西平相关的副作用频率是通过用治疗加权的逆概率调整数据来计算的。结果 卡马西平的初始应答者比例为 88.3%，90%。9% 与奥卡西平。特发性 (15%) 和继发性 (27%) 难治性患者的数量显着高于经典三叉神经痛 (6%)，(p<0.05)。在接受卡马西平治疗的 53 名患者 (29.6%) 和接受奥卡西平治疗的 22 名患者 (12.6%) 中，主要副作用导致治疗中断或剂量减少至不令人满意的水平。与奥卡西平（30.3%，p<0.0001）相比，接受卡马西平治疗的患者（43.6%）发生副作用的频率更高。继发性和特发性患者的治疗中断频率高于经典三叉神经痛患者（p<0.05）。结论 我们的真实世界研究表明，卡马西平和奥卡西平对大多数三叉神经痛患者有效；尽管如此，副作用仍然是一个主要问题，