A comparative study of hydrocortisone versus deflazacort in drug-resistant epilepsy of childhood
A comparative study of hydrocortisone versus deflazacort in drug-resistant epilepsy of childhood
复制标题
DOI：
10.1016/j.eplepsyres.2008.04.016
复制
发表时间：
2008-09-01
影响因子：
2.2
通讯作者：
Balestri, Paolo
中科院分区：
文献类型：
--
作者：
Grosso, Salvatore;Farnetani, Mariangela;Balestri, Paolo
类固醇常用于治疗难治性癫痫。Deflazacort显示出与泼尼松相似的效果，但副作用不那么令人担忧。在这项研究中，我们首先比较了地夫可特与氢化可的松在耐药癫痫儿童中的疗效、安全性和癫痫复发率。这是一项开放、非盲、随机的临床研究，共有35名儿童患有耐药癫痫。这项研究持续了12个月。第1组（16例患者）接受氢化可的松治疗6个月;第2组（19例患者）在整个研究期间接受地夫可特治疗。治疗6个月后评价药物疗效和耐受性。研究开始后12个月评估癫痫复发率，治疗6个月后，氢化可的松在44%的患者中有效（应答者，癫痫发作频率降低>50%）。Deflazacort在47%的患者中有效（P= 0.9）。使用氢化可的松的患者中有37%发生了不良事件，而使用地夫可特的患者中没有发生不良事件（P=0.002）。研究结束时，第1组的癫痫复发率显著高于第2组（P=0.04），氢化可的松可能有助于治疗严重耐药的儿童癫痫。然而，其影响可能是短暂的。地夫可特应考虑作为癫痫性脑病的治疗药物。这种药物与氢化可的松一样有效，可以长期用于治疗，副作用不那么令人担忧。(C)2008 Elsevier B. V.保留所有权利。
Steroids are commonly used for the treatment of intractable epilepsy. Deflazacort has shown similar effects to prednisone, but with a less worrying adverse-effect profile. In this study, we first compared the efficacy, safety, and seizure relapse rate of deflazacort versus hydrocortisone in children affected by drug-resistant epilepsies.This was an open, non-blinded, randomized clinical study of 35 children affected by drugresistant epilepsies. The study tasted 12 months. Group 1 (16 patients) received hydrocortisone for 6 months; group 2 (19 patients) was treated with deflazacort for the entire study period. Drug efficacy and tolerability were evaluated after 6 months of therapy. Seizure relapse rates were evaluated 12 months after the start of the study.After 6 months of therapy, hydrocortisone was effective in 44% of patients (responders, with a decrease in seizure frequency of >50%). Deflazacort was effective in 47% of patients (P= 0.9). Adverse events occurred in 37% of patients using hydrocortisone and in none of those using deflazacort (P=0.002). At the end of the study, seizure relapse rate resulted significantly higher in group 1 than in group 2 (P=0.04).Hydrocortisone may be useful in the treatment of severely drug-resistant childhood epilepsies. However, its effects may be transient. Deflazacort should be considered in the therapeutic armamentarium for epileptic encephalopathies. The drug is as effective as hydrocortisone and may be used in therapy for a long period, with a less worrying adverse-effect profile. (C) 2008 Elsevier B.V. All rights reserved.