27th October 2008
National Institute for Health and Clinical Excellence (NICE) - National Government Agency [Non-U.S.]
Summary,


GUIDELINE OBJECTIVE(S)

To assess the clinical and cost-effectiveness of the newer antiepileptic drugs gabapentin, lamotrigine, levetiracetam, oxcarbazepine, tiagabine, topiramate and vigabatrin for the management of epilepsy in people who have not benefited from treatment with the older antiepileptic drugs

TARGET POPULATION

Adults with epilepsy who have not benefited from treatment with the older antiepileptic drugs

INTERVENTIONS AND PRACTICES CONSIDERED

1. Antiepileptic drug treatment as monotherapy or combination therapy:
* Gabapentin
* Lamotrigine
* Levetiracetam
* Oxcarbazepine
* Tiagabine
* Topiramate
* Vigabatrin
2. Assessment of risks and benefits of drugs in women of child-bearing potential
3. Referral to specialists in persons with first seizure
4. Review of and monitoring of treatment

MAJOR OUTCOMES CONSIDERED

* Clinical effectiveness, primarily:
o Proportion of seizure-free participants
o Proportion of participants experiencing at least a 50% reduction in seizure frequency (i.e., responders)
o Time to exit/withdrawal
o Time to first seizure
o All quality of life outcomes
o All outcomes relating to cognitive function
o Safety (incidence of adverse events, mortality rate) and tolerability (incidence of withdrawals)
* Cost-effectiveness