Objective

This study investigated the long-term response and response patterns to antiepileptic drugs (AEDs) in patients with newly diagnosed epilepsy.

Methods

Patients who had been newly diagnosed with epilepsy and had at least 3-year follow-up records were enrolled. Their long-term response and response patterns to AEDs were retrospectively analyzed. Patients were divided into two groups, a controlled group and an uncontrolled group, according to whether 3-year seizure freedom (3YSF) was achieved. Multiple logistic regression analyses were used to identify risk factors associated with a poor drug response.

Results

Of the 472 patients with epilepsy, 180 achieved immediate seizure control, 36 achieved early seizure control, 118 achieved late seizure control, and 138 did not achieve 3YSF. Patients who achieved 3YSF (334/472, 70.8%) were categorized into the controlled group. Among them, 53.9% (180/334) achieved 3YSF immediately, 10.8% (36/334) achieved 3YSF within 6 months, and 35.3% (118/334) achieved 3YSF after 6 months. Also in this group, 228 (228/472, 48.3%), 84 (84/472, 17.8%), 15 (15/472, 3.2%), and 7 (7/472, 1.5%) patients achieved 3YSF on the first, second, third, and fourth regimen, respectively. Multivariate analyses showed that multiple seizure types (odds ratio [OR] = 3.903, 95% confidence interval [CI]: 2.098–7.264; P < 0.001] and polytherapy (OR = 5.093, 95% CI: 3.183–8.149; P < 0.001) were independent risk factors for a poor drug response.

Conclusion

The 3YSF rate in this cohort was 70.8%. More than half of the patients achieved long-term remission immediately after treatment. The probability of attaining 3YSF decreased with the increase in number of drug regimens, especially in patients who experienced failure of two treatment regimens.

中文翻译：

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新诊断癫痫患者抗癫痫药物的长期反应和反应模式

 客观的

本研究调查了新诊断癫痫患者对抗癫痫药物 (AED) 的长期反应和反应模式。

 方法

纳入新诊断癫痫且有至少 3 年随访记录的患者。回顾性分析了他们对 AED 的长期反应和反应模式。根据是否实现3年无癫痫发作（3YSF），将患者分为两组：对照组和非对照组。使用多重逻辑回归分析来识别与药物反应不良相关的危险因素。

 结果

在 472 例癫痫患者中，180 例实现了癫痫发作立即控制，36 例实现了早期癫痫发作控制，118 例实现了晚期癫痫发作控制，138 例未实现 3YSF。达到 3YSF 的患者（334/472，70.8%）被分为对照组。其中，53.9%（180/334）立即实现3YSF，10.8%（36/334）在6个月内实现3YSF，35.3%（118/334）在6个月后实现3YSF。同样在该组中，228 名 (228/472, 48.3%)、84 名 (84/472, 17.8%)、15 名 (15/472, 3.2%) 和 7 名 (7/472, 1.5%) 患者在分别为第一、第二、第三和第四方案。多变量分析显示，多种癫痫类型（比值比 [OR] = 3.903，95% 置信区间 [CI]：2.098–7.264； P < 0.001] 和多药治疗（OR = 5.093，95% CI：3.183–8.149； P < 0.001） ）是药物反应不良的独立危险因素。

 结论

该队列的 3YSF 率为 70.8%。超过一半的患者在治疗后立即获得长期缓解。达到 3YSF 的概率随着药物治疗方案数量的增加而降低，尤其是在经历了两种治疗方案失败的患者中。