Study of Predictors of Response to Anti Epilepsy in Epilepsy

Study Overview
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Brief Summary
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Pharmacoresistant epilepsy remains around 30% despite the development of 25 anti epileptic drugs. Of course, this can be explained by pharmacoresistant epileptic brain diseases, as exemplified by some genetic diseases. However, the lack of specific guidelines for the choice of the anti epileptic drugs (apart from generalized and partial epilepsy) and the very large number of drugs with different and sometimes complex metabolism are challenges for neurologists. Among the 30 % of pharmacoresistant epilepsy, there is a part related to pharmacokinetic drawbacks that could be overcome with a more rigorous approach (i.e. dosage and pharmacogenetics tools). Moreover, the new anti epileptic drugs have metabolism more unrelated with the cytochrome P450 and less generalised adverse events. However, their metabolism could be more complexe (i.e. the less known Uridine 5'-diphospho-glucuronyltransferase (UGT) pathway) and bring more insidious neurological adverse events (i.e. depression, anxiety exacerbation, cognitive disorders worsening) which could largely impede the observance and the quality of life even if the number of seizure is reduced or not. The goal is to determine the predictive and the modulating factors of pharmacoresistance with a global analysis (i.e. whatever the anti epileptic drugs) and with a specific analysis (drug by drug) from a cohort of 1000 patients.

Detailed Description
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The goal is to determine the predictive and the modulating factors of pharmacoresistance with a global analysis (i.e. whatever the anti epileptic drugs) and with a specific analysis (drug by drug with their specific metabolism pathways) from a cohort of 1000 patients. The response to the antiepileptic drugs modification will be analyse 3 months after the modification, with the analysis of the number of seizures, the quality of life, the Clinical Global Impression, the adverse events, the systematic dosage of all the molecules (residual concentration just before the taken) and the pharmacogenetic analysis of the main metabolism pathways and the main pharmacodynamic targets.

Official Title
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Study of Predictors of Response to Anti Epilepsy in Epilepsy

Conditions
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Seizure

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Epileptic patients who required a treatment adaptation Exclusion Criteria: patients unable to give reliable information and without caregiver pregnancy Severe comorbidity, which would impede interpretation

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Clinical global impression of the patient | Clinical global impression assessment | 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of seizure | recorded on the agenda of patients | 3 months | 
| Quality of life | Analyse with the Quality Of Life In Epilepsy Questionnaire | 3 months | 
| Adverse events | reported by the patients with a particular attention to attention and concentration worsening on interview | 3 months | 
| Concentration of the anti epileptic drug | plasmatic drug concentration will be systematically | 3 months | 
| Pharmacogenetics of the uridine 5'-diphosphate glucuronosyltransférases (UGT1A1, UGT2B7, UGT1A4) | the metabolism pathways of the drug | 3 months | 
| Pharmacogenetics of the Cytochrome P450 (2D6, 2C9, 2C19) | the metabolism pathways of the drug | 3 months | 
| Depression inventory for epilepsy | Neurological Disorders Depression Inventory for Epilepsy | 3 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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epilepsy, pharmacoresistant, antiepileptic drug, pharmacokinetic, pharmacodynamic, pharmacogenetic