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Prescription patterns of antiseizure drugs in tuberous sclerosis complex (TSC)-associated epilepsy: a multicenter cohort study from Germany and review of the literature

2021; Taylor & Francis; Volume: 14; Issue: 6 Linguagem: Inglês

10.1080/17512433.2021.1911643

1751-2441

Adam Strzelczyk, Janina Grau, Thomas Bast, Astrid Bertsche, U Bettendorf, Andreas Hahn, Hans Hartmann, Christoph Hertzberg, Frauke Hornemann, Ilka Immisch, Julia Jacobs, Kerstin Alexandra Klotz, Gerhard Kluger, Susanne Knake, Markus Knuf, Gerhard Kurlemann, Klaus Marquard, Patrick May, Sascha Meyer, Hiltrud Muhle, Karen Müller‐Schlüter, Felix von Podewils, Felix Rosenow, Susanne Ruf, Matthias Sauter, Hannah Schäfer, Jan-Ulrich Schlump, Susanne Schubert‐Bast, Steffen Syrbe, Charlotte Thiels, Regina Trollmann, Adelheid Wiemer‐Kruel, Bernd Wilken, Bianca Zukunft, Johann Philipp Zöllner,

Polyomavirus and related diseases

Objective Seizures are a primary and early disease manifestation of Tuberous Sclerosis Complex (TSC). We aimed to describe the age-stratified patterns of antiseizure drug (ASD) treatments among children, adolescents, and adults with TSC in Germany. Additionally, we reviewed real-world and clinical study evidence regarding ASD utilization in patients with TSC.Methods We evaluated the pattern of routine ASD use and everolimus prescriptions based on a 2019 multicenter survey of 268 individuals with TSC-associated epilepsy. We contextualized the results with a structured review of real-world and clinical study evidence.Results TSC-associated epilepsy treatment comprises a wide variety of ASDs. In this German sample, the majority of patients were treated with polytherapy, and lamotrigine (34.7%), valproate (32.8%), oxcarbazepine (28.7%), vigabatrin (19.0%), and levetiracetam (17.9%) were identified as the most-commonly used ASDs. In addition, everolimus was used by 32.5% of patients. In adherence to current TSC guidelines, the disease-modifying ASD vigabatrin was widely used in children (58% below the age of 5 years), whereas treatment in adults did not necessarily reflect guideline preference for (partial) GABAergic ASDs.Conclusions The selection of ASDs for patients with TSC-associated epilepsy follows well-evaluated recommendations, including the guidelines regarding vigabatrin use in children. Several characteristics, such as the comparatively high frequency of valproate use and polytherapy, reflect the severity of TSC-associated epilepsy.