Time to 12-month remission and treatment failure for generalised and unclassified epilepsy
- Laura J Bonnett1,
- Catrin Tudur Smith1,
- David Smith2,
- Paula R Williamson1,
- David Chadwick2,
- Anthony G Marson3
- 1Department of Biostatistics, University of Liverpool, Liverpool, UK
- 2Department of Neurology, The Walton Centre Foundation NHS Trust, Liverpool, UK
- 3Department of Molecular and Clinical Pharmacology, University of Liverpool, UK
- Correspondence to Professor Anthony G Marson, Department of Molecular and Clinical Pharmacology, University of Liverpool, Clinical Sciences Centre for Research and Education, Lower Lane, Fazakerley, Liverpool L9 7LJ, UK;
- Received 6 June 2013
- Revised 13 October 2013
- Accepted 19 October 2013
- Published Online First 29 November 2013
Objectives To develop prognostic models for time to 12-month remission and time to treatment failure after initiating antiepileptic drug monotherapy for generalised and unclassified epilepsy.
Methods We analysed data from the Standard and New Antiepileptic Drug (arm B) study, a randomised trial that compared initiating treatment with lamotrigine, topiramate and valproate in patients diagnosed with generalised or unclassified epilepsy. Multivariable regression modelling was used to investigate how clinical factors affect the probability of achieving 12-month remission and treatment failure.
Results Significant factors in the multivariable model for time to 12-month remission were having a relative with epilepsy, neurological insult, total number of tonic-clonic seizures before randomisation, seizure type and treatment. Significant factors in the multivariable model for time to treatment failure were treatment history (antiepileptic drug treatment prior to randomisation), EEG result, seizure type and treatment.
Conclusions The models described within this paper can be used to identify patients most likely to achieve 12-month remission and most likely to have treatment failure, aiding individual patient risk stratification and the design and analysis of future epilepsy trials.
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