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Efficacy of Valproate in Partial Epilepsy and Patient Compliance and Satisfaction with Long Acting Valproate Form [Epilepsi]
Epilepsi. 2007; 13(2): 73-82

Efficacy of Valproate in Partial Epilepsy and Patient Compliance and Satisfaction with Long Acting Valproate Form

Nerses Bebek1, Hacer Bozdemir2, Sevim Baybas3, Erhan Bilir4, Nilgün Araç5, Seher Naz Yeni6, Ali Akyol7, Destina Yalçın8, Aytaç Yiğit9, Ali Kemal Erdemoğlu10, Kezban Arslan2, Vedat Sözmen3
1Department Of Neurology; İstanbul University, İstanbul Medical School, İstanbul, Turkey.
2Department Of Neurology, Çukurova University Medical School, Adana, Turkey
32. Neurology Clinic, Bakırköy Education And Research Hospital For Psychiatric And Nervous Diseases, Istanbul, Turkey
4Department Of Neurology, Gazi University Medical School, Ankara, Turkey
5Department Of Neurology, Ege University Medical School, İzmir, Turkey
6Department Of Neurology, İstanbul University, Cerrahpaşa Medical School, İstanbul, Turkey
7Department Of Neurology, Adnan Menderes University Medical School, Aydın, Turkey
8Neurology Clinic, Şişli Etfal Education And Research Hospital, İstanbul, Turkey
9Department Of Neurology, Ankara University, Medical School, Ankara, Turkey
10Department Of Neurology, Kırıkkale University Medical School, Kırıkkale, Turkey

OBJECTIVE: The aims of this multi-centre cross-over study were to evaluate the efficacy of valproate in patients with partial epilepsy and compliance with the controlled-release formulation (valproate-CR).
METHODS: Ninety-four patients were included in ten centres and 81.9% completed the study. Clinical and demographic features were assessed at baseline, treatment compliance and satisfaction, efficacy and adverse events were evaluated at four visits. Seizure frequency, incidence of adverse events, treatment compliance and patient satisfaction differed significantly between the two treatment periods, with significant improvements in all measures following the switch to valproate-CR.
RESULTS: At first visit, 30.5% of patients were either seizure free or experienced rare seizures and were 62.5% at the fifth visit (p<0.001). Adverse events were observed in 35 (37.6%) at the second visit, while this number was 19 patients (25%) at the fifth visit. Treatment compliance was 82.2% at the second visit and this ratio increased to 97.4% at the fifth visit after the transition to long acting valproate form (p=0.001). At study-end, 84.9% of patients were satisfied with the treatment and 74.4% of patients were highly improved.
CONCLUSION: In conclusion, use of valproate-CR was associated with a lower incidence of side-effects and improved patient compliance and satisfaction.

Keywords: Valproate, epilepsy, myclonus, controlled release


Valproate' ’ın Parsiyel Epilepsiye Etkisi ve Uzun Etkili Valproate Formuna Hasta Uyumu ve Memnuniyeti

Nerses Bebek1, Hacer Bozdemir2, Sevim Baybas3, Erhan Bilir4, Nilgün Araç5, Seher Naz Yeni6, Ali Akyol7, Destina Yalçın8, Aytaç Yiğit9, Ali Kemal Erdemoğlu10, Kezban Arslan2, Vedat Sözmen3
1Department Of Neurology; İstanbul University, İstanbul Medical School, İstanbul, Turkey.
2Department Of Neurology, Çukurova University Medical School, Adana, Turkey
32. Neurology Clinic, Bakırköy Education And Research Hospital For Psychiatric And Nervous Diseases, Istanbul, Turkey
4Department Of Neurology, Gazi University Medical School, Ankara, Turkey
5Department Of Neurology, Ege University Medical School, İzmir, Turkey
6Department Of Neurology, İstanbul University, Cerrahpaşa Medical School, İstanbul, Turkey
7Department Of Neurology, Adnan Menderes University Medical School, Aydın, Turkey
8Neurology Clinic, Şişli Etfal Education And Research Hospital, İstanbul, Turkey
9Department Of Neurology, Ankara University, Medical School, Ankara, Turkey
10Department Of Neurology, Kırıkkale University Medical School, Kırıkkale, Turkey

AMAÇ: Çok merkezli, çapraz geçişli çalışmanın amacı parsiyel epilepsili hastalarda valproate etkinliğini ve kontrollü salınım formülasyonuyla (valproate-CR) uyumunun değerlendirilmesidir.
YÖNTEMLER: On merkezden 94 hasta çalışmaya katılmış ve %81,9’u çalışmayı tamamlamıştır. Klinik ve demografik özellikler başlangıçta belirtilmiştir, tedavi uyumu ve memnuniyeti, etkinlik ve advers olaylar dört vizitte değerlendirilmiştir. Nöbet sıklığı, advers olayların insidansi, tedavi uyumu ve hasta memnuniyeti, valproate-CR’a geçiþi takiben tüm ölçümlerdeki anlamlı iyileşme ile iki tedavi süresi arasında anlamlı olarak fark mevcuttu.
BULGULAR: İlk vizitte hastaların %30,5’inde ve beşinci vizitte %62,5’inde ya nöbet olmadı ya da nöbetler seyrekleşti (p<0.001). Advers olaylar ikinci vizitte 35 (37.6%) iken, beşinci vizitte 19 (25%) hastada gözlenmiştir. Tedavi uyumu ikinci vizitte %82,2 idi ve beşinci vizitte uzun etkili valproat forma geçişten sonra oran %97,4’e yükselmiştir. (p=0.001).Çalışmanın sonunda hastaların %84,9’u tedaviden memnundu ve hastaların %74,4’ü iyileşmişti.
SONUÇ: Sonuç olarak valproate-CR kullanımı yan etkilerin insidansının düşüklüğü, hasta uyumu ve memnuniyetindeki iyileşme ile ilişkilidir.

Anahtar Kelimeler: Valproate, epilepsi, miyokloni, uzun etkili


Nerses Bebek, Hacer Bozdemir, Sevim Baybas, Erhan Bilir, Nilgün Araç, Seher Naz Yeni, Ali Akyol, Destina Yalçın, Aytaç Yiğit, Ali Kemal Erdemoğlu, Kezban Arslan, Vedat Sözmen. Efficacy of Valproate in Partial Epilepsy and Patient Compliance and Satisfaction with Long Acting Valproate Form. Epilepsi. 2007; 13(2): 73-82

Corresponding Author: Nerses Bebek


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