Clinical Research Of Oxcarbazepine,Perampanel And Levetiracetam As First-line Monotherapy On Focal Epilepsy

Objective:To compare the efficacy and safety of oxcarbazepine,levetiracetam and perampanel as first-line monotherapy in the treatment of focal epilepsy.Recently,oxcarbazepine(OXC)has been widely recognized in the treatment of focal epilepsy,and recommended by the International League Against Epilepsy(ILAE)as the first-line drug for focal epilepsy;Levetiracetam(LEV)has been proved effective in the treatment of focal epilepsy by several randomized controlled trials.As the third generation of antiepileptic drug,perampanel(PER)has been approved for adjuvant treatment of focal seizures with or without secondary generalized seizures in China.This study compared the efficacy and safety of the first single drug of OXC,LEV and PER in the treatment of focal epilepsy,providing a high-level clinical evidence-based basis for the selection of drug treatment for focal epilepsy.Method:The clinical data of patients with focal epilepsy who were newly diagnosed in the Department of Neurology of the Affiliated Hospital of Qingdao University and treated with OXC,LEV or PER as the first choice were collected,and the basic demographic data,type of epilepsy,trauma history,head imaging,family history and other information of the patients were recorded.The efficacy was evaluated by comparing the seizures and quality of life of the patients in the three groups,and the safety was evaluated by comparing the occurrence of adverse reactions in the three groups.Results:According to the first choice of drugs,they were divided into OXC,LEV and PER group,respectively.Among them,OXC group had 90 cases,LEV group had 53 cases,PER group had 43 cases.After 6 months of treatment,the improvement of seizures in OXC group was better than that in LEV group and PER group,with statistical difference(P=0.031 for OXC and LEV,P=0.025 for OXC and PER,P<0.05),while there was no statistical difference between LEV group and PER group in improving seizures(P=0.870,P>0.05).OXC group,LEV group and PER group can effectively improve the quality of life of epileptic patients,and there is no statistical difference among the three groups(P>0.05);There was no statistical difference in the incidence of adverse reactions among OXC group,LEV group and PER group(P>0.05),and the incidence of adverse reactions was low.Conclusion:1.Compared with LEV and PER,OXC has a better effect in the treatment of focal epilepsy.2.OXC,LEV and PER are safe in the treatment of focal epilepsy,and there is no significant difference among them.3.OXC is still the first-line monotherapy for focal epilepsy,while LEV and PER can also achieve good results as the first-line monotherapy for focal epilepsy.