會議議程
講者簡介
2022/8/13 08:30~11:50 Room A Hall (第一會議室) 2F
- Symposium (1) Epilepsy, Neurocritical, Stroke
Update in Neurology
- Time
- Topic
- Speaker
- Moderator
- 09:00~09:30
- Optimal choice of antiseizure medication and current situation in Taiwan
- Speaker:
謝良博
- Moderator:
黃欽威
- Dr 謝良博
- MD
-
副院長
台中澄清
醫學教育研究部主任
台中澄清
E-mail：lphsieh624@yahoo.com.tw
Executive Summary：
Dr. Liang-Po Hsieh accomplished his neurology specialist training at Chang Gung Memorial Hospital, Taoyuan, Taiwan. He became the attending doctor of neurology department at Cheng-Ching Hospital, Taichung, Taiwan since 1996. Dr. Hsieh was the Vice superintendent and Chair of Medical Education Department at Cheng-Ching Hospital since 2015 till now. He behaved the president or Taiwan Epilepsy Society form 2019-2021. Now a day, Dr. Hsieh is the executive supervisor of Taiwan Epilepsy Society and executive director of Taiwan Epilepsy Association.
Dr. Hsieh started his research interest in epidemiology of epilepsy in Taiwan. He used the data of National Health Insurance Research Database (NHIRD) of Taiwan to estimate the prevalence and incidence rate of epilepsy in Taiwan. And described the prescription patterns and dosages of antiepileptic drugs in prevalent patients in Taiwan.
Dr. Liang-Po Hsieh accomplished his neurology specialist training at Chang Gung Memorial Hospital, Taoyuan, Taiwan. He became the attending doctor of neurology department at Cheng-Ching Hospital, Taichung, Taiwan since 1996. Dr. Hsieh was the Vice superintendent and Chair of Medical Education Department at Cheng-Ching Hospital since 2015 till now. He behaved the president or Taiwan Epilepsy Society form 2019-2021. Now a day, Dr. Hsieh is the executive supervisor of Taiwan Epilepsy Society and executive director of Taiwan Epilepsy Association.
Dr. Hsieh started his research interest in epidemiology of epilepsy in Taiwan. He used the data of National Health Insurance Research Database (NHIRD) of Taiwan to estimate the prevalence and incidence rate of epilepsy in Taiwan. And described the prescription patterns and dosages of antiepileptic drugs in prevalent patients in Taiwan.
Lecture Abstract：
The decision of when and how to treat epilepsy should take into consideration the impact of seizures on the patient versus the potential positive and negative effects of medication. Treatment with AEDs may not be straightforward; there is the potential for side-effects, toxicity and pharmacological interaction with other drugs.
When considering treatment options, it is essential to adopt a personalized approach including seizure type, seizure syndrome, concomitant diseases and specific etiological risk factors. Making an evidence-based informed decision about the most appropriate first-line pharmacological therapy is essential.
The current pattern of prescribed antiepileptic drugs (AED) is unclear when the newer AEDs are available in the early 21th century. We evaluated 118,937 prevalent epileptic patients in 2016 from a comprehensive coverage health care system. We found that predominant therapy model was monotherapy. The proportion of AED monotherapy was also higher in patients with dementia and stroke. The top three antiepileptic monotherapies were valproic acid (28.7%), levetiracetam (19.1%), and phenytoin (16.9%).
We also evaluated 73,891 incident epileptic patients between 2013 and 2016 from real-world settings. We found that the top five most commonly used AEDs as monotherapy were valproic acid, phenytoin, levetiracetam, gabapentin and oxcarbazepine. Valproic acid was the first choice of all AEDs (more than 30%) while levetiracetam has replaced phenytoin as the second choice since 2015. Factors associated with whether receiving the newer AEDs in the first prescription included year of diagnosis, gender, income level, previous or coexisting comorbidities, and characteristics of care providers (level of accreditation, volume, location and urbanization).
The decision of when and how to treat epilepsy should take into consideration the impact of seizures on the patient versus the potential positive and negative effects of medication. Treatment with AEDs may not be straightforward; there is the potential for side-effects, toxicity and pharmacological interaction with other drugs.
When considering treatment options, it is essential to adopt a personalized approach including seizure type, seizure syndrome, concomitant diseases and specific etiological risk factors. Making an evidence-based informed decision about the most appropriate first-line pharmacological therapy is essential.
The current pattern of prescribed antiepileptic drugs (AED) is unclear when the newer AEDs are available in the early 21th century. We evaluated 118,937 prevalent epileptic patients in 2016 from a comprehensive coverage health care system. We found that predominant therapy model was monotherapy. The proportion of AED monotherapy was also higher in patients with dementia and stroke. The top three antiepileptic monotherapies were valproic acid (28.7%), levetiracetam (19.1%), and phenytoin (16.9%).
We also evaluated 73,891 incident epileptic patients between 2013 and 2016 from real-world settings. We found that the top five most commonly used AEDs as monotherapy were valproic acid, phenytoin, levetiracetam, gabapentin and oxcarbazepine. Valproic acid was the first choice of all AEDs (more than 30%) while levetiracetam has replaced phenytoin as the second choice since 2015. Factors associated with whether receiving the newer AEDs in the first prescription included year of diagnosis, gender, income level, previous or coexisting comorbidities, and characteristics of care providers (level of accreditation, volume, location and urbanization).