Studies from Goethe-University in the Area of Epilepsy Described (The Burden of Severely Drug-Refractory Epilepsy: A Comparative Longitudinal…

Managed Care Weekly Digest

Studies from Goethe-University in the Area of Epilepsy Described (The Burden of Severely Drug-Refractory Epilepsy: A Comparative Longitudinal Evaluation of Mortality, Morbidity, Resource Use, and Cost Using German Health Insurance Data)

By a News Reporter-Staff News Editor at Managed Care Weekly Digest -- Current study results on Central Nervous System Diseases and Conditions - Epilepsy have been published. According to news originating from Frankfurt, Germany, by NewsRx correspondents, research stated, "To evaluate long-term outcome of three years and treatment patterns of patients suffering from severely drug-refractory epilepsy (SDRE). This analysis was population-based and retrospective, with data collected from four million individuals insured by statutory German health insurance."

Our news journalists obtained a quote from the research from Goethe-University, "ICD-10 codes for epilepsy (G40*) and intake of anticonvulsants were used to identify prevalent cases, which were then compared with a matched cohort drawn from the population at large. Insurance data were available from 2008 to 2013. Any patient who had been prescribed with at least four different antiepileptic drugs (AEDs) in an 18-month period was defined as an SDRE case. A total of 769 patients with SDRE were identified. Of these, 19% were children and adolescents; the overall mean age was 42.3 years, 45.4% were female and 54.6% male. An average of 2.7 AEDs per patient was prescribed during the first follow-up year. The AEDs most commonly prescribed were: levetiracetam (53.5%), lamotrigine (41.4%), valproate (41.3%), lacosamide (20.4%), and topiramate (17.8%). During 3-year follow-up, there was an annual rate of hospitalization in the range 42.7 to 55%, which was significantly higher than the 11.6-12.8% (<0.001) for the matched controls. Admissions to hospital because of epilepsy ranged between 1.7 and 1.9 per year, with an average duration for each epilepsy-caused hospitalization of 10-11.1 days. The number of comorbidities for SDRE patients was significantly increased compared with the matched controls: depression (28% against 10%), vascular disorders (22% against 5%), and injury rates were also higher (head 16% against 3%, trunk and limbs 16% against 8%). The 3-year mortality rate for SDRE patients was 14% against 2.1% in the matched cohort. SDRE patients are treated with AED polytherapy for all of the 3-year follow-up period. They are hospitalized more frequently than the general population and show increased morbidity levels and a sevenfold increase in mortality rate over 3 years."

According to the news editors, the research concluded: "Further examination is required of ways in which new approaches to treatment could lead to better outcomes in severely affected patients."

For more information on this research see: The Burden of Severely Drug-Refractory Epilepsy: A Comparative Longitudinal Evaluation of Mortality, Morbidity, Resource Use, and Cost Using German Health Insurance Data. Frontiers In Neurology, 2017;8():712 (see also Central Nervous System Diseases and Conditions - Epilepsy).

The news correspondents report that additional information may be obtained from A. Strzelczyk, Epilepsy Center Frankfurt Rhine-Main, Dept. of Neurology, Goethe University, Frankfurt am Main, Germany. Additional authors for this research include C. Griebel, W. Lux, F. Rosenow and J.P Reese.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.3389/fneur.2017.00712. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

Keywords for this news article include: Europe, Germany, Epilepsy, Frankfurt, Epidemiology, Health Insurance, Health and Medicine, Brain Diseases and Conditions, Central Nervous System Diseases and Conditions.