Efficacy, Retention and Tolerability of Everolimus in Patients with Tuberous Sclerosis Complex: A Survey-Based Study on Patients' Perspectives.


Journal

CNS drugs
ISSN: 1179-1934
Titre abrégé: CNS Drugs
Pays: New Zealand
ID NLM: 9431220

Informations de publication

Date de publication:
10 2021
Historique:
accepted: 21 06 2021
pubmed: 19 7 2021
medline: 17 2 2022
entrez: 18 7 2021
Statut: ppublish

Résumé

The approval of everolimus (EVE) for the treatment of angiomyolipoma (2013), subependymal giant cell astrocytoma (2013) and drug-refractory epilepsy (2017) in patients with tuberous sclerosis complex (TSC) represents the first disease-modifying treatment option available for this rare and complex genetic disorder. The objective of this study was to analyse the use, efficacy, tolerability and treatment retention of EVE in patients with TSC in Germany from the patient's perspective. A structured cross-age survey was conducted at 26 specialised TSC centres in Germany and by the German TSC patient advocacy group between February and July 2019, enrolling children, adolescents and adult patients with TSC. Of 365 participants, 36.7% (n = 134) reported the current or past intake of EVE, including 31.5% (n = 115) who were taking EVE at study entry. The mean EVE dosage was 6.1 ± 2.9 mg/m From the patients' perspective, EVE is an effective and relatively well-tolerated disease-modifying treatment option for children, adolescents and adults with TSC, associated with a high long-term retention rate that can be individually considered for each patient. Everolimus therapy should ideally be supervised by a centre experienced in the use of mechanistic target of rapamycin inhibitors, and adverse effects should be monitored on a regular basis.

Sections du résumé

BACKGROUND
The approval of everolimus (EVE) for the treatment of angiomyolipoma (2013), subependymal giant cell astrocytoma (2013) and drug-refractory epilepsy (2017) in patients with tuberous sclerosis complex (TSC) represents the first disease-modifying treatment option available for this rare and complex genetic disorder.
OBJECTIVE
The objective of this study was to analyse the use, efficacy, tolerability and treatment retention of EVE in patients with TSC in Germany from the patient's perspective.
METHODS
A structured cross-age survey was conducted at 26 specialised TSC centres in Germany and by the German TSC patient advocacy group between February and July 2019, enrolling children, adolescents and adult patients with TSC.
RESULTS
Of 365 participants, 36.7% (n = 134) reported the current or past intake of EVE, including 31.5% (n = 115) who were taking EVE at study entry. The mean EVE dosage was 6.1 ± 2.9 mg/m
CONCLUSIONS
From the patients' perspective, EVE is an effective and relatively well-tolerated disease-modifying treatment option for children, adolescents and adults with TSC, associated with a high long-term retention rate that can be individually considered for each patient. Everolimus therapy should ideally be supervised by a centre experienced in the use of mechanistic target of rapamycin inhibitors, and adverse effects should be monitored on a regular basis.

Identifiants

pubmed: 34275102
doi: 10.1007/s40263-021-00839-4
pii: 10.1007/s40263-021-00839-4
pmc: PMC8478774
doi:

Substances chimiques

Immunosuppressive Agents 0
Everolimus 9HW64Q8G6G

Banques de données

DRKS
['DRKS00016045']

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1107-1122

Informations de copyright

© 2021. The Author(s).

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Auteurs

Laurent M Willems (LM)

Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe-University Frankfurt, Schleusenweg 2-16 (Haus 95), 60528, Frankfurt am Main, Germany.
LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Frankfurt am Main, Germany.

Felix Rosenow (F)

Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe-University Frankfurt, Schleusenweg 2-16 (Haus 95), 60528, Frankfurt am Main, Germany.
LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Frankfurt am Main, Germany.

Susanne Schubert-Bast (S)

Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe-University Frankfurt, Schleusenweg 2-16 (Haus 95), 60528, Frankfurt am Main, Germany.
LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Frankfurt am Main, Germany.
Department of Neuropediatrics, Goethe-University Frankfurt, Frankfurt am Main, Germany.

Gerhard Kurlemann (G)

St. Bonifatius Hospital, Lingen, Germany.

Johann Philipp Zöllner (JP)

Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe-University Frankfurt, Schleusenweg 2-16 (Haus 95), 60528, Frankfurt am Main, Germany.
LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Frankfurt am Main, Germany.

Thomas Bast (T)

Epilepsy Center Kork, Clinic for Children and Adolescents, Kehl-Kork, Germany.

Astrid Bertsche (A)

Department of Neuropediatrics, University Hospital for Children and Adolescents, Rostock, Germany.

Ulrich Bettendorf (U)

Neuropediatric Practice, Hirschaid, Germany.

Daniel Ebrahimi-Fakhari (D)

Department of General Pediatrics, Division of Neuropediatrics, University Hospital Münster, Münster, Germany.

Janina Grau (J)

Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe-University Frankfurt, Schleusenweg 2-16 (Haus 95), 60528, Frankfurt am Main, Germany.
LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Frankfurt am Main, Germany.

Andreas Hahn (A)

Department of Neuropediatrics, Justus-Liebig-University Gießen, Gießen, Germany.

Hans Hartmann (H)

Clinic for Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany.

Christoph Hertzberg (C)

Department of Neuropediatrics, Vivantes Klinikum Neukölln, Berlin, Germany.

Frauke Hornemann (F)

Department of Neuropediatrics, Leipzig University Hospital for Children and Adolescents, Leipzig, Germany.

Ilka Immisch (I)

Epilepsy Center Hessen and Department of Neurology, Philipps-University Marburg, Marburg (Lahn), Germany.

Julia Jacobs (J)

Department of Neuropediatrics and Muscle Disorders, Center for Pediatrics, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany.
Department of Pediatrics and Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.

Karl Martin Klein (KM)

Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe-University Frankfurt, Schleusenweg 2-16 (Haus 95), 60528, Frankfurt am Main, Germany.
LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Frankfurt am Main, Germany.
Departments of Clinical Neurosciences, Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute and Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.

Kerstin A Klotz (KA)

Department of Neuropediatrics and Muscle Disorders, Center for Pediatrics, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany.
Berta-Ottenstein-Programme, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany.

Gerhard Kluger (G)

Clinic for Neuropediatrics and Neurorehabilitation, Epilepsy Center for Children and Adolescents, Schön Klinik Vogtareuth, Vogtareuth, Germany.
Research Institute, Rehabilitation, Transition and Palliation, PMU Salzburg, Salzburg, Austria.

Susanne Knake (S)

Epilepsy Center Hessen and Department of Neurology, Philipps-University Marburg, Marburg (Lahn), Germany.

Markus Knuf (M)

Department of Pediatrics, Klinikum Worms, Worms, Germany.
Department of Pediatrics, University Medicine Mainz, Mainz, Germany.

Klaus Marquard (K)

Department of Pediatric Neurology, Psychosomatics and Pain Management, Klinikum Stuttgart, Stuttgart, Germany.

Thomas Mayer (T)

Epilepsy Center Kleinwachau, Radeberg, Germany.

Sascha Meyer (S)

Department of Neuropediatrics, University Children´s Hospital of Saarland, Homburg, Germany.

Hiltrud Muhle (H)

Department of Neuropediatrics, Christian-Albrechts-University Kiel and University Hospital Schleswig-Holstein, Kiel, Germany.

Karen Müller-Schlüter (K)

Epilepsy Center for Children, University Hospital Neuruppin, Brandenburg Medical School, Neuruppin, Germany.

Felix von Podewils (F)

Department of Neurology, Epilepsy Center, University Medicine Greifswald, Greifswald, Germany.

Susanne Ruf (S)

Department of Neuropediatrics, University Hospital Tübingen, Tübingen, Germany.

Matthias Sauter (M)

Klinikum Kempten, Klinikverbund Allgäu, Kempten/Allgäu, Germany.

Hannah Schäfer (H)

Division of Nephrology, Medizinische Klinik und Poliklinik IV, Klinikum der LMU München - Innenstadt, München, Germany.
Department of Nephrology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.

Jan-Ulrich Schlump (JU)

Department of Neuropediatrics, University of Witten/Herdecke, Herdecke, Germany.

Steffen Syrbe (S)

Division of Pediatric Epileptology, Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany.

Charlotte Thiels (C)

Department of Neuropediatrics and Social Pediatrics, St. Josef-Hospital, University Hospital of Pediatrics and Adolescent Medicine, Ruhr-University Bochum, Bochum, Germany.

Regina Trollmann (R)

Department of Neuropediatrics, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany.

Adelheid Wiemer-Kruel (A)

Epilepsy Center Kork, Clinic for Children and Adolescents, Kehl-Kork, Germany.

Bernd Wilken (B)

Department of Neuropediatrics, Klinikum Kassel, Kassel, Germany.

Bianca Zukunft (B)

Department of Nephrology and Internal Intensive Care, Charité - University Medicine Berlin, Berlin, Germany.

Adam Strzelczyk (A)

Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe-University Frankfurt, Schleusenweg 2-16 (Haus 95), 60528, Frankfurt am Main, Germany. strzelczyk@med.uni-frankfurt.de.
LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Frankfurt am Main, Germany. strzelczyk@med.uni-frankfurt.de.
Epilepsy Center Hessen and Department of Neurology, Philipps-University Marburg, Marburg (Lahn), Germany. strzelczyk@med.uni-frankfurt.de.

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