Dose–Response Study of Vigabatrin as Add-On Therapy in Patients with Uncontrolled Complex Partial Seizures
Article first published online: 2 AUG 2005
Volume 40, Issue 1, pages 74–82, January 1999
How to Cite
Dean, C., Mosier, M. and Penry, K. (1999), Dose–Response Study of Vigabatrin as Add-On Therapy in Patients with Uncontrolled Complex Partial Seizures. Epilepsia, 40: 74–82. doi: 10.1111/j.1528-1157.1999.tb01991.x
- Issue published online: 2 AUG 2005
- Article first published online: 2 AUG 2005
- Accepted July 28, 1998.
- Complex partial seizures;
- Add-on therapy;
- Uncontrolled seizures
Summary: Purpose: This placebo-controlled, randomized, double-blind, multicenter study examined the efficacy and safety of three daily doses of vigabatrin (VGB; 1, 3, or 6 g) as add-on therapy in 174 patients with previously uncontrolled complex partial seizures with or without secondary generalization.
Methods: A 12-week pretreatment assessment period was followed by drug therapy with a 6-week titration period and a 12-week maintenance phase.
Results: VGB doses of 3 and 6 g/day reduced median monthly frequency of seizures by 4.3 and 4.5 seizures, respectively, compared with 0.2 seizures for placebo (p = 0.0001). The percentages of patients classified as therapeutic successes (≤50% reduction in seizure frequency) were 7% for placebo and 24, 51, and 54% for patients taking daily VGB doses of 1, 3, and 6 g, respectively; the comparison with placebo was significant for all treatment groups. The linear trend for dose response was highly significant (p ≥ 0.0001) for both median monthly seizure frequency and therapeutic success. Vigabatrin was well tolerated, causing no clinically significant changes in laboratory parameters, brain magnetic resonance imaging, evoked potentials, cognitive function, or psychosocial tests. Fatigue, drowsiness, and dizziness were the most common treatment-related adverse events in all treatment groups. Dropouts due to adverse events were higher in the 6-g/day group.
Conclusions: VGB was significantly more effective than placebo as add-on therapy in reducing seizure frequency. VGB at 3 and 6 g/day produced the best efficacy: however, adverse events may limit the use of the 6-g/day dose in some patients.