Treatment of epilepsy may be more efficient with antiepileptic drugs combined with a different clinical mechanism of action than with the combination of two drugs with the same mechanism of action, according to a new study from the University of Texas Health Science Center at San Antonio.
Researchers analyzed health insurance data of more than 96 million Americans and searched the combination of drugs prescribed for recently diagnosed epilepsy patients. The reason for the analysis is that the mechanism of action, determined by specific biochemical interactions, produces a certain pharmacological effect and can result indifferent outcomes.
“We found that combining antiepileptic drugs with different mechanisms of action had greater effectiveness as measured by longer treatment persistence and lower risk for hospitalization and ER visits. The research demonstrates that a rational approach for combining antiepileptic drugs is effective for the management for people with intractable epilepsy, which is a concern for about 3 million Americans,” said Dr. Jose E. Cavazos, M.D., Ph.D., a professor of neurology, pharmacology and physiology at the UT Health Science Center, co-director of the South Texas Comprehensive Epilepsy Center, a joint effort of UT Medicine San Antonio and the University Health System. and lead author of the study recently published online by JAMA Neurology.
During the study, the scientists identified 8,600 cases of recently diagnosed epilepsy that were prescribed with two drugs with different mechanisms of action and studied the patients’ records, in terms of hospitalizations, emergency room visits and total health costs, to determine the effectiveness of the treatment. Using the health insurance companies’ data, researchers were also able to determine the length of time that people continued to refill their medication, which suggested the period in which their medications kept working.
This is the first study that proves how to combine the antiepileptic medication, according to Cavazos. “It really took an analysis of a large sample to be able to select individuals who were taking their first or second drug combination.”
The study, which was an investigator-initiated hypothesis study and third-party health claim data and statistical analysis, received funding from pharmaceutical company Eisai.