PMID- 33914900
OWN - NLM
STAT- MEDLINE
DCOM- 20211001
LR  - 20211001
IS  - 1600-0404 (Electronic)
IS  - 0001-6314 (Linking)
VI  - 144
IP  - 3
DP  - 2021 Sep
TI  - Long-term effects of zonisamide in adult patients with intellectual disability.
PG  - 275-282
LID - 10.1111/ane.13443 [doi]
AB  - OBJECTIVE: This study aimed to evaluate the tolerability and efficacy of 
      zonisamide (ZNS) in adult patients with drug-resistant epilepsy and intellectual 
      disability (ID) at our epilepsy centre. PATIENTS AND METHODS: By conducting a 
      monocentric, open-label observational study based on standardized seizure records 
      we retrospectively assessed 87 patients (39 female, mean age 40.6 +/- 13.6, range 
      18-75 years) with ID and drug-resistant epilepsy. Evaluation, including 
      calculation of retention rate, was performed for the intervals 3-6, 9-12 and 
      21-24 months after ZNS initiation. The Clinical Global Impressions 
      Scale-Improvement (CGI-I) was used to detect qualitative changes in seizure 
      severity and clinical status. Via regression analysis and the generalized 
      estimating equations approach, we examined changes in body weight and impact of 
      patient age also considering associations with other patient characteristics. 
      RESULTS: The retention rate after 24 months was 60%. 28% discontinued ZNS therapy 
      due to increasing seizure frequency, lack of efficacy or adverse events (AEs). 
      Sedation (38%), language impairment (19%), challenging behaviour (10%), mild rash 
      (10%) and dizziness (10%) were the commonest AEs. The responder rate was 40%, 
      eight patients (9%) became seizure free. We found CGI-I to be dose-dependent. 
      Regarding changes in body weight, we observed no difference between patients 
      continuing or withdrawing ZNS therapy and responders or non-responders. Though, 
      we identified older age as a significant risk factor for weight loss. 
      CONCLUSIONS: Zonisamide may provide a safe and efficient therapeutic option for 
      patients with ID and drug-resistant epilepsy. However, weight status should be 
      carefully monitored, especially in elderly patients.
CI  - (c) 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
FAU - Eck, Kattrinna
AU  - Eck K
AUID- ORCID: 0000-0002-3469-5395
AD  - Department of Neurology, Epilepsy Center, Sana-Krankenhaus Rummelsberg (teaching 
      hospital of the Friedrich-Alexander-Universitat Erlangen-Nurnberg), 
      Schwarzenbruck, Germany.
FAU - Rauch, Christophe
AU  - Rauch C
AD  - Department of Neurology, Epilepsy Center, Sana-Krankenhaus Rummelsberg (teaching 
      hospital of the Friedrich-Alexander-Universitat Erlangen-Nurnberg), 
      Schwarzenbruck, Germany.
FAU - Kerling, Frank
AU  - Kerling F
AD  - Department of Neurology, Epilepsy Center, Sana-Krankenhaus Rummelsberg (teaching 
      hospital of the Friedrich-Alexander-Universitat Erlangen-Nurnberg), 
      Schwarzenbruck, Germany.
FAU - Hamer, Hajo
AU  - Hamer H
AD  - Department of Neurology, Friedrich-Alexander-Universitat Erlangen-Nurnberg, 
      Erlangen, Germany.
FAU - Winterholler, Martin
AU  - Winterholler M
AD  - Department of Neurology, Epilepsy Center, Sana-Krankenhaus Rummelsberg (teaching 
      hospital of the Friedrich-Alexander-Universitat Erlangen-Nurnberg), 
      Schwarzenbruck, Germany.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20210429
PL  - Denmark
TA  - Acta Neurol Scand
JT  - Acta neurologica Scandinavica
JID - 0370336
RN  - 0 (Anticonvulsants)
RN  - 459384H98V (Zonisamide)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Anticonvulsants/therapeutic use
MH  - Female
MH  - Humans
MH  - *Intellectual Disability/drug therapy
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - Young Adult
MH  - Zonisamide/*therapeutic use
OTO - NOTNLM
OT  - drug-resistant epilepsy
OT  - intellectual disability
OT  - weight loss
OT  - zonisamide
EDAT- 2021/04/30 06:00
MHDA- 2021/10/02 06:00
CRDT- 2021/04/29 17:39
PHST- 2021/04/06 00:00 [revised]
PHST- 2021/02/05 00:00 [received]
PHST- 2021/04/13 00:00 [accepted]
PHST- 2021/04/30 06:00 [pubmed]
PHST- 2021/10/02 06:00 [medline]
PHST- 2021/04/29 17:39 [entrez]
AID - 10.1111/ane.13443 [doi]
PST - ppublish
SO  - Acta Neurol Scand. 2021 Sep;144(3):275-282. doi: 10.1111/ane.13443. Epub 2021 Apr 
      29.