This will be a descriptive, exploratory cohort study. Broadly, the objective of this study is to assess the evolution of (1) Anti-epileptic drug (AED) prescription patterns and sequencing, and (2) treatment outcomes in real-life clinical practice in England. Patients will be selected with a definite diagnosis of epilepsy between April 1st 2003 and the latest available data, where diagnosis is defined as a diagnosis of epilepsy made by a neurologist in the in- or outpatient setting, as recorded in HES or primary care data. Patients will be categorised as having been diagnosed in one of 3 time periods (eras). Treatment patterns between eras will be explored, as the percentage of patients prescribed a certain AED. For every patient, treatment outcome will be assessed, as remission (absence of seizure codes and new AED attempts), possible misdiagnosis (presence of a differential diagnosis code, cessation of all AED treatment, and absence of further seizure codes), or unclear outcome. Outcome will be analysed using Kaplan-Meier methods, with or without the use of cumulative distribution methods, in cases of competing risks.
The following possible outcomes will be defined. The outcomes are mutually exclusive. 1. One-year, 2-year, 5-year remission from seizures (mutually exclusive) 2. Possible misdiagnosis 3. Unclear outcome and untreated at end of follow-up 4. Unclear outcome and treated at end of follow-up
Simon Borghs - Chief Investigator - UCB Pharma SA - UK
Simon Borghs - Corresponding Applicant - UCB Pharma SA - UK
Graham Powell - Collaborator - University of Liverpool
John Logan - Collaborator - UCB Pharma SA - UK
Victor A. Kiri - Collaborator - Parexel International (UK) Ltd