دورية أكاديمية
Modified Atkins diet versus levetiracetam for non-surgical drug-resistant epilepsy in children: A randomized open-label study.
| العنوان: | Modified Atkins diet versus levetiracetam for non-surgical drug-resistant epilepsy in children: A randomized open-label study. |
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| المؤلفون: | Archna; Department of Pediatrics (Neurology division), Kalawati Saran Children's Hospital and Lady Hardinge Medical College, New Delhi, India., Garg D; Department of Neurology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India., Goel S; Department of Pediatrics (Neurology division), Kalawati Saran Children's Hospital and Lady Hardinge Medical College, New Delhi, India., Mukherjee SB; Department of Pediatrics (Neurology division), Kalawati Saran Children's Hospital and Lady Hardinge Medical College, New Delhi, India., Pemde HK; Department of Pediatrics (Neurology division), Kalawati Saran Children's Hospital and Lady Hardinge Medical College, New Delhi, India., Jain P; Epilepsy Program, Division of Neurology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada., Sharma S; Department of Pediatrics (Neurology division), Kalawati Saran Children's Hospital and Lady Hardinge Medical College, New Delhi, India. Electronic address: sharma.suvasini@gmail.com. |
| المصدر: | Seizure [Seizure] 2022 Dec; Vol. 103, pp. 61-67. Date of Electronic Publication: 2022 Oct 14. |
| نوع المنشور: | Randomized Controlled Trial; Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: England NLM ID: 9306979 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-2688 (Electronic) Linking ISSN: 10591311 NLM ISO Abbreviation: Seizure Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: London : Elsevier Original Publication: London : Baillière Tindall, c1992- |
| مواضيع طبية MeSH: | Diet, High-Protein Low-Carbohydrate* , Drug Resistant Epilepsy*/drug therapy , Diet, Ketogenic*/adverse effects , Drug-Related Side Effects and Adverse Reactions*, Child ; Humans ; Levetiracetam/adverse effects ; Seizures/drug therapy ; Treatment Outcome |
| مستخلص: | Background: This study was undertaken to compare the efficacy of modified Atkins diet (MAD) among children with non-surgical drug-resistant epilepsy (DRE) to levetiracetam, when added to on-going anti-seizure medications. Methods: An open-label, randomized controlled trial among children aged 2-12 years with non-surgical DRE was conducted. Eligible children were randomized in a 1:1 ratio to receive add-on MAD or levetiracetam. Baseline and post-intervention seizure frequency at 12 weeks was determined from seizure logs maintained by parents. The primary outcome was the proportion of responders, i.e., patients who achieved > 50% seizure reduction from baseline. Adverse events were compared. Analysis was intention-to-treat. (NCT04172311) RESULTS: One hundred and one children were enrolled (MAD-51, levetiracetam-50). The majority of the enrolled children had generalized seizures of mixed types secondary to structural brain lesions and Lennox-Gastaut syndrome was the most common electroclinical syndrome (46%). The proportion of children with >50% seizure reduction at 12 weeks was significantly higher in the MAD arm compared to the levetiracetam arm (27/51(52.9%) vs 11/50(22%); p < 0.001). At 12-weeks post-intervention, the change in mean seizure frequency compared to baseline was -47.33 ± 39.57% in the MAD arm and -31.15 ± 32.18% in the levetiracetam arm (p = 0.03). Constipation (41.1%) was the most frequent adverse effect with MAD. Sedation/lethargy (18%) and anxiety and irritability (14%) were the most frequent adverse effects in the levetiracetam group. Conclusion: Addition of MAD was found to be superior to levetiracetam among children with non-surgical DRE with predominant generalized seizures in achieving seizure reduction at 12 weeks. Both treatments were well tolerated. Adverse effects, although higher with MAD, were expected side effects. Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. The authors have no conflicts of interest to disclose. (Copyright © 2022. Published by Elsevier Ltd.) |
| فهرسة مساهمة: | Keywords: Children; Drug-resistant epilepsy; Ketogenic diet; Levetiracetam; Modified Atkins diet |
| المشرفين على المادة: | 44YRR34555 (Levetiracetam) |
| تواريخ الأحداث: | Date Created: 20221028 Date Completed: 20221130 Latest Revision: 20221130 |
| رمز التحديث: | 20221213 |
| DOI: | 10.1016/j.seizure.2022.10.015 |
| PMID: | 36306706 |
| قاعدة البيانات: | MEDLINE |
Full Text via ClinicalKey 
Full Text Finder | تدمد: | 1532-2688 |
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| DOI: | 10.1016/j.seizure.2022.10.015 |