期刊
JOURNAL OF PEDIATRICS
卷 232, 期 -, 页码 220-+出版社
MOSBY-ELSEVIER
DOI: 10.1016/j.jpeds.2021.01.032
关键词
-
类别
资金
- National Institutes of Health [1K23NS116110, R21NS109669, R01DC016902, U54HD090257, RO1HL147261, RO1NS111166]
- National Science Foundation [1532061]
- Pediatric Epilepsy Research Foundation
- PCORI
- PCORnet
- University of Michigan
- Division Of Computer and Network Systems
- Direct For Computer & Info Scie & Enginr [1532061] Funding Source: National Science Foundation
In the US, benzodiazepines and antiseizure medications are the most common initial therapies prescribed for CSWS, but the study suggests that benzodiazepines and steroids are more effective than antiseizure medications. Treatment choice does not depend on baseline clinical variables, nor correlate with outcomes.
Objectives To determine how continuous spike and wave during slow wave sleep (CSWS) is currently managed and to compare the effectiveness of current treatment strategies using a database from 11 pediatric epilepsy centers in the US. Study design This retrospective study gathered information on baseline clinical characteristics, CSWS etiology, and treatment(s) in consecutive patients seen between 2014 and 2016 at 11 epilepsy referral centers. Treatments were categorized as benzodiazepines, steroids, other antiseizure medications (ASMs), or other therapies. Two measures of treatment response (clinical improvement as noted by the treating physician; and electroencephalography improvement) were compared across therapies, controlling for baseline variables. Results Eighty-one children underwent 153 treatment trials during the study period (68 trials of benzodiazepines, 25 of steroids, 45 of ASMs, 14 of other therapies). Children most frequently received benzodiazepines (62%) or ASMs (27%) as first line therapy. Treatment choice did not differ based on baseline clinical variables, nor did these variables correlate with outcome. After adjusting for baseline variables, children had a greater odds of clinical improvement with benzodiazepines (OR 3.32, 95%CI 1.57-7.04, P = .002) or steroids (OR 4.04, 95%CI 1.41-11.59, P = .01) than with ASMs and a greater odds of electroencephalography improvement after steroids (OR 3.36, 95% CI 1.09-10.33, P = .03) than after ASMs. Conclusions Benzodiazepines and ASMs are the most frequent initial therapy prescribed for CSWS in the US. Our data suggests that ASMs are inferior to benzodiazepines and steroids and support earlier use of these therapies. Multicenter prospective studies that rigorously assess treatment protocols and outcomes are needed.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据