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DC Field | Value | Language |
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dc.contributor | Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP | - |
dc.contributor.author | JACKSON, Michele C. | - |
dc.contributor.author | JAFARPOUR, Saba | - |
dc.contributor.author | KLEHM, Jacquelyn | - |
dc.contributor.author | THOME-SOUZA, Sigride | - |
dc.contributor.author | COUGHLIN, Francesca | - |
dc.contributor.author | KAPUR, Kush | - |
dc.contributor.author | LODDENKEMPER, Tobias | - |
dc.date.accessioned | 2017-10-24T13:24:37Z | - |
dc.date.available | 2017-10-24T13:24:37Z | - |
dc.date.issued | 2017 | - |
dc.identifier.citation | EPILEPSIA, v.58, n.9, p.1575-1585, 2017 | - |
dc.identifier.issn | 0013-9580 | - |
dc.identifier.uri | https://observatorio.fm.usp.br/handle/OPI/22168 | - |
dc.description.abstract | Objective: To evaluate the efficacy and safety of vigabatrin in pediatric epilepsy. Methods: We retrospectively reviewed patients with epilepsy treated with vigabatrin over a 2-year period at a pediatric tertiary center. We assessed the relationship between seizure frequency, etiology, vigabatrin dose, adverse events, medication discontinuation reasons, and electroencephalography (EEG) characteristics. Results: One hundred three patients followed at Boston Children's Hospital were treated with vigabatrin and had complete medical records. Within the follow-up interval, 69 (67%) of 103 patients had discontinued vigabatrin therapy. Two patients (1.9%) died during therapy for unknown reasons. Median age at vigabatrin initiation was 8 months (interquartile range [IQR] 5-15). Median starting dose was 48.1 mg/kg per day (IQR 29.8-52.3) with a median target of 100 mg/kg (IQR 81.9-107.9). Median treatment duration was 12.1 months (n = 89, IQR 5.0-22.9) overall, and 13.3 months (IQR 5.2-23.2) for patients who discontinued vigabatrin. The most common reasons for discontinuation were controlled seizures in 31 (43.7%) of 71 and unsatisfactory therapeutic effect in 23 (32.4%) of 71. Median percent seizure reduction from baseline to first follow- up was 83.3% (IQR 27.4-99.8) and 96.7% (IQR 43.3-100) to last follow-up. Twentyfour (38.7%) of 62 patients with a follow-up posttreatment remained seizure-free. Four patients who had initially achieved seizure freedom relapsed. Patients with structural/ metabolic etiology had greater median percent seizure reduction at first follow-up than patients with genetic etiology (98.7% vs. 61.4%, respectively, p = 0.001). Hypsarrhythmia resolved after therapy in 18 of 20 (90%, 95% confidence interval [CI] 70-97) patients with pretreatment hypsarrhythmia, and 2 patients presented with hypsarrhythmia posttreatment. Risk of having hypsarrhythmia was reduced by 32% (95% CI 14.9-49.1) posttreatment. Significance: Vigabatrin is efficacious in all seizure types and resolved hypsarrhythmia in most patients. In this series with a median treatment duration of 12.1 months, vigabatrin had a good safety profile with a low rate of discontinuation due to nonophthalmologic and ophthalmologic adverse effects. | - |
dc.description.sponsorship | Lundbeck Inc. | - |
dc.language.iso | eng | - |
dc.publisher | WILEY | - |
dc.relation.ispartof | Epilepsia | - |
dc.rights | restrictedAccess | - |
dc.subject | Epileptic Spasms | - |
dc.subject | Hypsarrhythmia | - |
dc.subject | Efficacy | - |
dc.subject | Pediatric | - |
dc.subject | Adverse events | - |
dc.subject.other | tuberous sclerosis complex | - |
dc.subject.other | diagnosed partial seizures | - |
dc.subject.other | kingdom infantile spasms | - |
dc.subject.other | long-term | - |
dc.subject.other | refractory epilepsy | - |
dc.subject.other | childhood epilepsy | - |
dc.subject.other | randomized-trial | - |
dc.subject.other | therapy | - |
dc.subject.other | onset | - |
dc.subject.other | acth | - |
dc.title | Effect of vigabatrin on seizure control and safety profile in different subgroups of children with epilepsy | - |
dc.type | article | - |
dc.rights.holder | Copyright WILEY | - |
dc.identifier.doi | 10.1111/epi.13836 | - |
dc.identifier.pmid | 28691157 | - |
dc.subject.wos | Clinical Neurology | - |
dc.type.category | original article | - |
dc.type.version | publishedVersion | - |
hcfmusp.author.external | JACKSON, Michele C.:Harvard Med Sch, Boston Childrens Hosp, Dept Neurol, Div Epilepsy & Clin Neurophysiol, Boston, MA USA | - |
hcfmusp.author.external | JAFARPOUR, Saba:Harvard Med Sch, Boston Childrens Hosp, Dept Neurol, Div Epilepsy & Clin Neurophysiol, Boston, MA USA | - |
hcfmusp.author.external | KLEHM, Jacquelyn:Harvard Med Sch, Boston Childrens Hosp, Dept Neurol, Div Epilepsy & Clin Neurophysiol, Boston, MA USA | - |
hcfmusp.author.external | COUGHLIN, Francesca:Harvard Med Sch, Boston Childrens Hosp, Dept Neurol, Div Epilepsy & Clin Neurophysiol, Boston, MA USA | - |
hcfmusp.author.external | KAPUR, Kush:Harvard Med Sch, Boston Childrens Hosp, Dept Neurol, Div Epilepsy & Clin Neurophysiol, Boston, MA USA | - |
hcfmusp.author.external | LODDENKEMPER, Tobias:Harvard Med Sch, Boston Childrens Hosp, Dept Neurol, Div Epilepsy & Clin Neurophysiol, Boston, MA USA | - |
hcfmusp.description.beginpage | 1575 | - |
hcfmusp.description.endpage | 1585 | - |
hcfmusp.description.issue | 9 | - |
hcfmusp.description.volume | 58 | - |
hcfmusp.origem | WOS | - |
hcfmusp.origem.id | 2-s2.0-85022329687 | - |
hcfmusp.origem.id | WOS:000409338700013 | - |
hcfmusp.publisher.city | HOBOKEN | - |
hcfmusp.publisher.country | USA | - |
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dc.description.index | MEDLINE | - |
dc.identifier.eissn | 1528-1167 | - |
hcfmusp.citation.scopus | 16 | - |
hcfmusp.scopus.lastupdate | 2024-04-12 | - |
Appears in Collections: | Artigos e Materiais de Revistas Científicas - HC/IPq |
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