„Rationale“ Pharmakotherapie gescheitert View Full Text


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Article Info

DATE

2018-09-20

AUTHORS

Bernhard J. Steinhoff, Matthias Bacher, Inge Fazekas, Christoph Kurth, Anne‑Sophie Wendling, Anke M. Staack

ABSTRACT

Wir berichten den Fall einer inzwischen 71 Jahre alten Patientin mit einer idiopathisch generalisierten Epilepsie mit Myoklonien und generalisierten tonisch-klonischen Anfällen bei photoparoxysmaler Reaktion Grad 4 nach Waltz, die trotz der üblichen medikamentösen und expositionsreduzierenden prophylaktischen Maßnahmen über Jahre nicht anfallsfrei geworden war. Sie hatte bei der Proof-of-Concept-Studie teilgenommen, bei der lange vor den Zulassungsstudien der Effekt von Einmaldosen von Brivaracetam (BRV) auf die photoparoxysmale Reaktion (PPR) photosensibler Epilepsiepatienten getestet worden war. In dieser Studie hatte sich ein eindeutig positiver Effekt von BRV auf die PPR in unserem Fall nachweisen lassen. Deshalb behandelten wir sie nach Zulassung von BRV zur Behandlung von Epilepsien mit fokalen und sekundär generalisierten Anfällen im Sinne einer Off-Label-Anwendung mit BRV als Zusatzmedikation bis zu einer Dosishöhe von 200 mg. Leider scheiterte dieser „rationale“ Therapieansatz, weil sich sowohl generalisierte tonisch-klonische Anfälle als auch insbesondere die PPR nicht unterdrücken ließen. Diese kasuistische Erfahrung suggeriert, dass die Übertragbarkeit der Ergebnisse einer Einmaldosisstudie auf die spätere Wirksamkeit unter chronischen Therapiebedingungen fraglich ist. More... »

PAGES

1-5

References to SciGraph publications

Journal

TITLE

Zeitschrift für Epileptologie

ISSUE

N/A

VOLUME

N/A

Author Affiliations

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s10309-018-0209-7

DOI

http://dx.doi.org/10.1007/s10309-018-0209-7

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1107125277


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34 schema:description Wir berichten den Fall einer inzwischen 71 Jahre alten Patientin mit einer idiopathisch generalisierten Epilepsie mit Myoklonien und generalisierten tonisch-klonischen Anfällen bei photoparoxysmaler Reaktion Grad 4 nach Waltz, die trotz der üblichen medikamentösen und expositionsreduzierenden prophylaktischen Maßnahmen über Jahre nicht anfallsfrei geworden war. Sie hatte bei der Proof-of-Concept-Studie teilgenommen, bei der lange vor den Zulassungsstudien der Effekt von Einmaldosen von Brivaracetam (BRV) auf die photoparoxysmale Reaktion (PPR) photosensibler Epilepsiepatienten getestet worden war. In dieser Studie hatte sich ein eindeutig positiver Effekt von BRV auf die PPR in unserem Fall nachweisen lassen. Deshalb behandelten wir sie nach Zulassung von BRV zur Behandlung von Epilepsien mit fokalen und sekundär generalisierten Anfällen im Sinne einer Off-Label-Anwendung mit BRV als Zusatzmedikation bis zu einer Dosishöhe von 200 mg. Leider scheiterte dieser „rationale“ Therapieansatz, weil sich sowohl generalisierte tonisch-klonische Anfälle als auch insbesondere die PPR nicht unterdrücken ließen. Diese kasuistische Erfahrung suggeriert, dass die Übertragbarkeit der Ergebnisse einer Einmaldosisstudie auf die spätere Wirksamkeit unter chronischen Therapiebedingungen fraglich ist.
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