Observational studyEpilepsia2019
Validated outcome of treatment changes according to International League Against Epilepsy criteria in adults with drug-resistant focal epilepsy.
Observational study in Epilepsia, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
14 citing papers in PubMed.
- Epilepsy treatment over time: The chess game analogy for choosing, adjusting, and adding antiseizure medications.Epilepsia · 2026Review
- Redefining drug-resistant epilepsy: Insights from an Italian Delphi consensus study.Epilepsia open · 2025Article
- Epilepsy, neuroinflammation and cannabidiol What do we know thus far?Frontiers in pharmacology · 2025Review
- Prognosis of people with focal epilepsy treated with anti-seizure medications (ASMs): a narrative review of current evidence and future directions.BMJ neurology open · 2025Review
- Re-evaluating the placebo response in recent canine dietary epilepsy trials.BMC veterinary research · 2024Article
- Optimizing treatment persistence in epilepsy: a comparative analysis of combined antiseizure medications with different mechanisms of action.Therapeutic advances in neurological disorders · 2023Article
- Risk factors for Drug-resistant Epilepsy (DRE) and a nomogram model to predict DRE development in post-traumatic epilepsy patients.CNS neuroscience & therapeutics · 2022Article
- Development and validation of a nomogram for the early prediction of drug resistance in children with epilepsy.Frontiers in pediatrics · 2022Article
- Pregabalin Add-On vs. Dose Increase in Levetiracetam Add-On Treatment: A Real-Life Trial in Dogs With Drug-Resistant Epilepsy.Frontiers in veterinary science · 2022Article
- Definitions and Risk Factors for Drug-Resistant Epilepsy in an Adult Cohort.Frontiers in neurology · 2021Article
- Critical Appraisal of Cenobamate as Adjunctive Treatment of Focal Seizures in Adults.Neuropsychiatric disease and treatment · 2021Review
- Drug Resistance in Epilepsy: Clinical Impact, Potential Mechanisms, and New Innovative Treatment Options.Pharmacological reviews · 2020Review
- Validated outcome of treatment changes according to International League Against Epilepsy criteria in adults with drug-resistant focal epilepsy.Epilepsia · 2019Observational
- Cenobamate: Real-World Experience Matches Clinical Trials.Epilepsy currentsArticle
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
objectiveAlthough many studies have attempted to describe treatment outcomes in patients with drug-resistant epilepsy, results are often limited by the adoption of nonhomogeneous criteria and different definitions of seizure freedom. We sought to evaluate treatment outcomes with a newly administered antiepileptic drug (AED) in a large population of adults with drug-resistant focal epilepsy according to the International League Against Epilepsy (ILAE) outcome criteria.
methodsThis is a multicenter, observational, prospective study of 1053 patients with focal epilepsy diagnosed as drug-resistant by the investigators. Patients were assessed at baseline and 6, 12, and 18 months, for up to a maximum of 34 months after introducing another AED into their treatment regimen. Drug resistance status and treatment outcomes were rated according to ILAE criteria by the investigators and by at least two independent members of an external expert panel (EP).
resultsA seizure-free outcome after a newly administered AED according to ILAE criteria ranged from 11.8% after two failed drugs to 2.6% for more than six failures. Significantly fewer patients were rated by the EP as having a "treatment failure" as compared to the judgment of the investigator (46.7% vs 62.9%, P < 0.001), because many more patients were rated as "undetermined outcome" (45.6% vs 27.7%, P < 0.001); 19.3% of the recruited patients were not considered drug-resistant by the EP. SIGNIFICANCE: This study validates the use of ILAE treatment outcome criteria in a real-life setting, providing validated estimates of seizure freedom in patients with drug-resistant focal epilepsy in relation to the number of previously failed AEDs. Fewer than one in 10 patients achieved seizure freedom on a newly introduced AED over the study period. Pseudo drug resistance could be identified in one of five cases.
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