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Clinical and cost effectiveness of levetiracetam vs valproate

EAN 2019
The longer-term clinical and cost effectiveness of levetiracetam and valproate in newly diagnosed generalised and unclassified epilepsy have been compared in a randomised trial [1]. Levetiracetam was not non-inferior to valproate for time to 12-month remission, and was inferior for time to treatment failure for inadequate seizure control and for time to 24-month remission. The so-called Standard And New Antiepileptic Drugs II (SANAD II) study was a randomised unblinded controlled trial comparing starting treatment with levetiracetam or valproate in patients with generalised (n=396) and unclassified (n=124) epilepsy. The trial was designed to assess the non-inferiority of levetiracetam for time to 12-month remission. Levetiracetam was not found to be non-inferior to valproate for this endpoint: HR 1.19 (non-inferiority margin: 1.314). The HR was not constant over time. After 3 years, there was little to no difference between the 12-month remission rates for...

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