Non-interventional surveillance study of adverse events in patients with epilepsy

Epilepsy is one of the most common seriousneurological disorders, affecting approximately50 million people worldwide (1). For patients withepilepsy, the goal of treatment is to achieve seizurefreedom with minimal adverse events (AEs) (2–4),as both of these factors can contribute to treatmentfailure, and adversely affect quality of life (5–8).Antiepileptic drugs (AEDs) may cause AEs, andmany of these are easily overlooked in everydayclinical practice (9). Mattson et al. (2, 10) haveused structured questionnaires to elicit patientconcerns about systemic and neurological effectsof AEDs throughout 1–3 years of follow-up. Theyand others have found that systematic assessmentusing standardized instruments may be helpful inidentifying AEs, understanding patient needs, andguiding medication changes (2, 8–12).Since the introduction of various new AEDs inthe early 1990s, treatment options for epilepsy haveincreased dramatically (13, 14), and newer AEDsappear to be better tolerated than older AEDs (15–18). However, further research is needed to confirmthe apparent improvement in tolerability offeredby some of the newer AEDs (19). Overall, the AEprofiles of AEDs are often determining factors indrug selection (19, 20). Also, monotherapy hasbeen associated with fewer AEs than polytherapy(9, 11, 12).The adverse Event SCAle in Patients withEpilepsy (aESCAPE) study explored the incidenceand type of AEs experienced by patients withepilepsy treated with AEDs (grouped into older+newer AEDs, and monotherapy and polytherapy)in a systematic and standardized way and assessedthe reasons for modifying AED therapy at thestudy visit.