Evidence map›Paper›PMID 36281833›Full record

ArticleEpilepsia open2023

Medical treatment in infants and young children with epilepsy: Off-label use of antiseizure medications. Survey Report of ILAE Task Force Medical Therapies in Children.

Jo Sourbron, Stéphane Auvin, Alexis Arzimanoglou, J Helen Cross, Hans Hartmann, Ronit Pressler, Kate Riney, Kenji Sugai, Jo M Wilmshurst, Elissa Yozawitz and 1 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Epilepsia open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Article
  2. Observational
  3. Article
  4. Article
  5. Pharmacogenetics and Oxcarbazepine in Children and Adolescents: BeyondJournal of child and adolescent psychopharmacology · 2024
    Review
  6. Review
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Jo SourbronSection Pediatric Neurology, Department of Development and Regeneration, University Hospital KU Leuven, Leuven, Belgium.ORCID 0000-0002-5319-6495
Stéphane AuvinA PHP, Service de Neurologie Pédiatrique, Hôpital Robert Debré, Paris, France.ORCID 0000-0003-3874-9749
Alexis ArzimanoglouEpilepsy Department, Member of the ERN EpiCARE, Sant Joan de Déu Hospital, Barcelona, Spain.ORCID 0000-0002-7233-2771
J Helen CrossGreat Ormond Street Hospital for Children, London, UK.ORCID 0000-0001-7345-4829
Hans HartmannClinic for Pediatric Kidney, Liver, and Metabolic Diseases, Hannover Medical School, Hannover, Germany.
Ronit PresslerGreat Ormond Street Hospital for Children, London, UK.ORCID 0000-0002-2905-6839
Kate RineySchool of Medicine, University of Queensland, Brisbane, Queensland, Australia.ORCID 0000-0002-1122-3555
Kenji SugaiDepartment of Child Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Japan.
Jo M WilmshurstDepartment of Pediatric Neurology, Red Cross War Memorial Children's Hospital, Neuroscience Institute, University of Cape Town, Cape Town, South Africa.ORCID 0000-0001-7328-1796
Elissa YozawitzIsabelle Rapin Division of Child Neurology of the Saul R Korey Department of Neurology, Montefiore Medical Center, New York City, New York, USA.ORCID 0000-0001-8230-8364
Lieven LagaeSection Pediatric Neurology, Department of Development and Regeneration, University Hospital KU Leuven, Leuven, Belgium.ORCID 0000-0002-7118-0139

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveAntiseizure medications (ASMs) remain the mainstay of epilepsy treatment. These ASMs have mainly been tested in trials in adults with epilepsy, which subsequently led to market authorization (MA). For treatment of - especially young - children with epilepsy, several ASMs do not have a MA and guidelines are lacking, subsequently leading to "off-label" use of ASMs. Even though "off-label" ASM prescriptions for children could lead to more adverse events, it can be clinically appropriate and rational if the benefits outweigh the risks. This could be the case if "on-label" ASM, in mono- or polytherapy, fails to achieve adequate seizure control.

methodsThe Medical Therapies Task Force of the International League Against Epilepsy (ILAE) Commission for Pediatrics performed a survey to study the current treatment practices in six classic, early life epilepsy scenarios. Our aim was not only to study first- and second-line treatment preferences but also to illustrate the use of "off-label" drugs in childhood epilepsies.

resultsOur results reveal that several ASMs (e.g. topiramate, oxcarbazepine, benzodiazepines) are prescribed "off-label" in distinct scenarios of young children with epilepsy. In addition, recent scientific guidelines were not always adopted by several survey respondents, suggesting a potential knowledge gap. SIGNIFICANCE: We report the relatively common use of "off-label" prescriptions that underlines the need for targeted and appropriately designed clinical trials, including younger patients, which will also result in the ability to generate evidence-based guidelines.

Indexed as

EpilepsyOff-Label UseChildChild, PreschoolHumansInfantOxcarbazepineSeizuresTopiramateOxcarbazepineTopiramatechildrenepilepsy treatmentInternational League Against Epilepsyoff-labelquestionnaire

Identifiers

PMID36281833
PMCPMC9977757

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.