新型抗癫痫药物及血清BDNF水平在疗效、安全性监测及生活质量中的作用研究

IF 3.2 Q2 Pharmacology, Toxicology and Pharmaceutics Current clinical pharmacology Pub Date : 2020-01-01 DOI:10.2174/1574884714666190312145409
Meral Demir, Emel O Akarsu, Hava O Dede, Nerses Bebek, Sevda O Yıldız, Betül Baykan, Ahmet G Akkan
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引用次数: 8

摘要

目的:探讨拉莫三嗪(LTG)、奥卡西平(OXC)、唑尼沙胺(ZNS)和拉科沙胺(LCM)等常用新型抗癫痫药物(NADs)的治疗药物监测(TDM)特征及其与脑源性神经营养因子(BDNF)的关系。此外,我们还研究了它们对生活质量(QoL)的影响。方法:80例使用NADs的癫痫患者和13例健康受试者进行横断面研究。参与者被随机分成几组。采用QOLIE-31检验评价生活质量。我们还准备并应用了“安全测试”。HPLC法测定TDM, ELISA法测定BDNF。结果:与健康受试者相比,癫痫患者的结婚率(p=0.049)、受教育程度(p小于0.001)和酒精使用(p=0.002)均较低。局灶性癫痫患者BDNF水平较高(p=0.013),受教育程度较高(p=0.016)。ltg多药组血清BDNF水平与ZNS水平呈负相关(p=0.042), OXC单药组血清MHD水平(OXC的10-单羟基衍生物,p=0.041)呈负相关。在癫痫发作频率方面,单药-多药治疗组BDNF无差异。总体健康状况与生活质量呈正相关(p小于0.001)。单药治疗组QOLIE-31总分(OS)(76.5±14.5)高于单药治疗组。OS (p小于0.001)、癫痫焦虑(SW, p=0.004)、认知(C, p小于0.001)、社会功能(SF, p小于0.001)在主要组间存在差异。健忘是最常见的不良影响。结论:TDM有助于临床医生使用更有效、更安全的NADs,而BDNF可能有助于TDM达到癫痫的治疗目标。
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Investigation of the Roles of New Antiepileptic Drugs and Serum BDNF Levels in Efficacy and Safety Monitoring and Quality of Life: A Clinical Research.

Objective: We aimed to determine the therapeutic drug monitoring (TDM) features and the relation to Brain-Derived Neurotrophic Factor (BDNF) of frequently used new antiepileptic drugs (NADs) including lamotrigine (LTG), oxcarbazepine (OXC), zonisamide (ZNS) and lacosamide (LCM). Moreover, we investigated their effect on the quality of life (QoL).

Methods: Eighty epileptic patients who had been using the NADs, and thirteen healthy participants were included in this cross-sectional study. The participants were randomized into groups. The QOLIE-31 test was used for the assessment of QoL. We also prepared and applied "Safety Test". HPLC method for TDM, and ELISA method for BDNF measurements were used consecutively.

Results: In comparison to healthy participants, epileptic participants had lower marriage rate (p=0.049), education level (p˂0.001), alcohol use (p=0.002). BDNF levels were higher in patients with focal epilepsy (p=0.013) and in those with higher education level (p=0.016). There were negative correlations between serum BDNF levels and serum ZNS levels (p=0.042) with LTGpolytherapy, serum MHD levels (a 10-monohydroxy derivative of OXC, p=0.041) with OXCmonotherapy. There was no difference in BDNF according to monotherapy-polytherapy, drugresistant groups, regarding seizure frequency. There was a positive correlation between total health status and QoL (p˂0.001). QOLIE-31 overall score (OS) was higher in those with OXCmonotherapy (76.5±14.5). OS (p˂0.001), seizure worry (SW, p=0.004), cognition (C, p˂0.001), social function (SF, p˂0.001) were different in the main groups. Forgetfulness was the most common unwanted effect.

Conclusion: While TDM helps the clinician to use more effective and safe NADs, BDNF may assist in TDM for reaching the therapeutic target in epilepsy.

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Current clinical pharmacology
Current clinical pharmacology PHARMACOLOGY & PHARMACY-
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期刊介绍: Current Clinical Pharmacology publishes frontier reviews on all the latest advances in clinical pharmacology. The journal"s aim is to publish the highest quality review articles in the field. Topics covered include: pharmacokinetics; therapeutic trials; adverse drug reactions; drug interactions; drug metabolism; pharmacoepidemiology; and drug development. The journal is essential reading for all researchers in clinical pharmacology.
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