000			a
999			_c18265 _d18265
003			OSt
005			20221118095549.0
008			221118b xxu||||| |||| 00| 0 eng d
040			_aAIKTC-KRRC _cAIKTC-KRRC
100			_919127 _aSarangi, Sudhir C.
245			_aAntiepileptic‑drug tapering and seizure recurrence: Correlation with serum drug levels and biomarkers in persons with epilepsy
250			_aVol.54(1), Jan-Feb
260			_aMumbai _bWolter Kluwer _c2022
300			_a24-32p.
520			_aOBJECTIVES: Antiepileptic‑drug (AED) serum level and inflammatory biomarkers are primarily monitored/assessed during epilepsy treatment for effective seizure control; however, their correlation with seizure recurrence (SR) following AED‑tapering has not been established, and this is being investigated in this study. MATERIALS AND METHODS: This prospective observational study enrolled persons with epilepsy (PWE) on AED monotherapy and going to start tapering after being seizure‑free for ≥2 years. Data regarding seizure episodes, AED‑treatment, and adverse events (using Liverpool Adverse Event profile [LAEP]‑score) were recorded. Serum AED levels using high‑performance liquid chromatography and biomarkers levels through enzyme‑linked immunosorbent assay kits were estimated at AED‑tapering commencement and at 6 months/SR time. RESULTS: Among 129 enrolled PWE (levetiracetam [n = 52], valproate [n = 34], carbamazepine [n = 29], and phenytoin [n = 14]), SR occurred in 23.3% during follow‑up (range 12–44 months). PWE with subtherapeutic serum AED level at the onset of tapering had higher SR (P = 0.004) than those with therapeutic or higher levels. Levetiracetam‑treated PWEs with SR have significantly low AED levels than PWE with no‑SR (P < 0.001). PWE had significantly raised inflammatory biomarkers (interleukin [IL]‑1 β, tumor necrosis factor [TNF]‑α, IL‑6, and high-mobility group box protein 1) and decreased IL‑10 than healthy control subjects. SR and no‑SR groups did not differ significantly in inflammatory markers except for higher IL‑1 β and TNF‑α levels in SR group (P = 0.001, 0.02, respectively). Improvement in LAEP score was observed in follow‑up visits without any difference between SR and no‑SR groups. CONCLUSION: Low serum AED levels (especially levetiracetam) and raised levels of TNF‑α and IL‑1 β during tapering commencement had a higher association with SR following AED‑tapering.
650		0	_94774 _aPHARMACOLOGY
700			_911256 _aSachin Kumar
773	0		_dAndheri - Mumbai Wolters Kluwer India Private Limited _x0253-7613 _tIndian Journal of Pharmacology
856			_uhttps://www.ijp-online.com/temp/IndianJPharmacol54124-157262_042206.pdf _yClick here
942			_2ddc _cAR