Epilepsy Research in Mali: A Pilot Pharmacokinetics Study on First-Line Antiepileptic Drug Treatment.
Carbamazepine
Epilepsy
Mali
Phenobarbital
Quality of life
Valproic acid
Journal
Journal of epilepsy research
ISSN: 2233-6249
Titre abrégé: J Epilepsy Res
Pays: Korea (South)
ID NLM: 101577886
Informations de publication
Date de publication:
Jun 2020
Jun 2020
Historique:
received:
12
03
2020
revised:
09
04
2020
accepted:
04
05
2020
entrez:
28
9
2020
pubmed:
29
9
2020
medline:
29
9
2020
Statut:
epublish
Résumé
The indication and benefit of plasma level of antiepileptic (AEDs) has been debating in the monitoring of people living with epilepsy and the epilepsy treatment gap has largely been documented in developed countries. This study was aimed to highlight the epilepsy treatment gap between rural and urban Mali. We conducted a pilot study on AEDs treatment from September 2016 to May 2019. For 6 months, 120 children and young adults living with epilepsy (rural site, 90; urban site, 30) received phenobarbital, valproic acid and/or carbamazepine. At our rural study site, we determined the AED plasma levels, monitored the frequency, severity and the duration of seizure, and administered monthly the McGill quality of life questionnaire. At our urban study site, each patient underwent an electroencephalogram and brain computed tomography scan without close monitoring. At the rural study site, patients were mostly on monotherapy; AED levels at 1 month (M1) (n=90) and at 3 months (M3) (n=27) after inclusion were normal in 50% at M1 versus 55.6% at M3, low in 42.2% at M1 versus 33.3% at M3 and high in 7.8% at M1 versus 11.1% at M3. AED levels at M1 and at M3 were significantly different Epilepsy diagnostic and treatment are a real concern in Mali. Our data showed appropriate AED treatment with close follow up resulted in a better quality of life of patients in rural Mali. We will promote the approach of personalized medicine in AED treatment in Mali.
Sections du résumé
BACKGROUND AND PURPOSE
OBJECTIVE
The indication and benefit of plasma level of antiepileptic (AEDs) has been debating in the monitoring of people living with epilepsy and the epilepsy treatment gap has largely been documented in developed countries. This study was aimed to highlight the epilepsy treatment gap between rural and urban Mali.
METHODS
METHODS
We conducted a pilot study on AEDs treatment from September 2016 to May 2019. For 6 months, 120 children and young adults living with epilepsy (rural site, 90; urban site, 30) received phenobarbital, valproic acid and/or carbamazepine. At our rural study site, we determined the AED plasma levels, monitored the frequency, severity and the duration of seizure, and administered monthly the McGill quality of life questionnaire. At our urban study site, each patient underwent an electroencephalogram and brain computed tomography scan without close monitoring.
RESULTS
RESULTS
At the rural study site, patients were mostly on monotherapy; AED levels at 1 month (M1) (n=90) and at 3 months (M3) (n=27) after inclusion were normal in 50% at M1 versus 55.6% at M3, low in 42.2% at M1 versus 33.3% at M3 and high in 7.8% at M1 versus 11.1% at M3. AED levels at M1 and at M3 were significantly different
CONCLUSIONS
CONCLUSIONS
Epilepsy diagnostic and treatment are a real concern in Mali. Our data showed appropriate AED treatment with close follow up resulted in a better quality of life of patients in rural Mali. We will promote the approach of personalized medicine in AED treatment in Mali.
Identifiants
pubmed: 32983953
doi: 10.14581/jer.20006
pii: jer-20006
pmc: PMC7494886
doi:
Types de publication
Journal Article
Langues
eng
Pagination
31-39Subventions
Organisme : Wellcome Trust
Pays : United Kingdom
Organisme : FIC NIH HHS
ID : U2R TW010673
Pays : United States
Informations de copyright
Copyright © 2020 Korean Epilepsy Society.
Déclaration de conflit d'intérêts
Conflict of Interest The authors declare that they have no conflicts of interest.
Références
Epilepsy Behav. 2018 Oct;87:131-136
pubmed: 30100226
Neuropsychiatr Dis Treat. 2007 Feb;3(1):117-31
pubmed: 19300542
Front Public Health. 2013 Sep 13;1:31
pubmed: 24350200
Curr Opin Neurol. 2012 Apr;25(2):179-86
pubmed: 22322413
Epilepsia. 2010 May;51(5):883-90
pubmed: 20067507
Adv Med. 2015;2015:876135
pubmed: 26556558
Indian J Pharmacol. 2015 Sep-Oct;47(5):551-4
pubmed: 26600647
Epilepsia. 2002;43 Suppl 6:21-5
pubmed: 12190974
Lancet Neurol. 2005 Jan;4(1):21-31
pubmed: 15620854
J Glob Health. 2012 Dec;2(2):020405
pubmed: 23289080
Curr Neuropharmacol. 2009 Jun;7(2):115-9
pubmed: 19949569
Front Neurol. 2018 May 02;9:276
pubmed: 29770117
Ther Adv Neurol Disord. 2010 Mar;3(2):85-92
pubmed: 21179601
Therapie. 2015 Sep-Oct;70(5):415-24
pubmed: 26071142
Per Med. 2008 Mar;5(2):123-131
pubmed: 29783348
Pharmacogenomics J. 2006 Nov-Dec;6(6):357-9
pubmed: 16505830
Bull Soc Pathol Exot. 2000 Nov;93(4):241-6
pubmed: 11204723
Ther Drug Monit. 2007 Jun;29(3):305-12
pubmed: 17529887
Epilepsia. 1986 Jan-Feb;27(1):60-5
pubmed: 3948819
Epilepsy Behav. 2014 May;34:58-67
pubmed: 24704566
Arch Dis Child. 2012 Apr;97(4):343-9
pubmed: 22328741
Epilepsia. 2008 Jul;49(7):1239-76
pubmed: 18397299
Epilepsia. 2000 Jun;41(6):765-74
pubmed: 10840411
P T. 2010 Jul;35(7):392-415
pubmed: 20689626
Lancet Neurol. 2014 Oct;13(10):1029-44
pubmed: 25231525
Ann Indian Acad Neurol. 2014 Jan;17(1):35-42
pubmed: 24753657
Arch Pediatr. 2010 Jun;17(6):688-90
pubmed: 20654843
Curr Opin Neurol. 2018 Apr;31(2):211-215
pubmed: 29324507
Sci Rep. 2019 May 27;9(1):7875
pubmed: 31133687