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Quality‐of‐life outcomes of initiating treatment with standard and newer antiepileptic drugs in adults with new‐onset epilepsy: Findings from the SANAD trial
Author(s) -
Jacoby Ann,
Sudell Maria,
Tudur Smith Catrin,
Crossley Joanne,
Marson Anthony G.,
Baker Gus A.
Publication year - 2015
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/epi.12913
Subject(s) - lamotrigine , oxcarbazepine , topiramate , medicine , quality of life (healthcare) , epilepsy , randomized controlled trial , carbamazepine , pediatrics , clinical trial , gabapentin , adverse effect , anticonvulsant , psychiatry , alternative medicine , nursing , pathology
Summary Objective To compare quality‐of‐life (QoL) outcomes over 2 years following initiation of treatment with a standard or newer antiepileptic drug ( AED ) in adults with new‐onset epilepsy. To examine the impact of seizure remission and failure of initial treatment on QoL outcomes measured over 2 years. Methods We conducted a pragmatic, randomized, unblinded, multicenter, parallel‐group clinical trial (the Standard and New Antiepileptic Drugs [SANAD] trial) comparing clinical and cost effectiveness of initiating treatment with carbamazepine versus lamotrigine, gabapentin, oxcarbazepine and topiramate, and valproate versus lamotrigine and topiramate. QoL data were collected by mail at baseline, 3 months, and at 1 and 2 years using validated measures. These data were analyzed using longitudinal data models. Continuous QoL measures, time to 12‐month remission and time to treatment withdrawal were explored using joint models. Results Baseline questionnaires were returned by 1,575 adults; 1,439 returned the 3‐month questionnaire, 1,274 returned the 1‐year questionnaire, and 1,121 returned the 2‐year questionnaire. There were few statistically significant differences between drugs over 2 years in QoL outcomes. Significant association was identified between QoL scores over the 2‐year time frame and the risk of experiencing a 12‐month remission or treatment withdrawal over that period. Significance The choice of initial treatment had no significant effect on QoL by 2‐year follow‐up. However, overall QoL was reduced with continued seizures, adverse events, and failure of the initial treatment.