Sodium valproate for epilepsy in rural China: An efficacy and safety assessment in primary care

摘要

Purpose: Sodium valproate (VPA) is a broad-spectrum anti-epileptic drug usually well tolerated. We conducted a pilot study to assess the feasibility, efficacy and side-effects of VPA in the treatment of convulsive epilepsy in primary care settings in rural China as an alternative to phenobarbital. Methods: People with convulsive epilepsy were identified at primary health care level and provided with VPA monotherapy. Local trained physicians identified participants, managed treatment, and carried out the follow-up, whilst diagnoses were confirmed by a neurologist. Participants were followed for 12 months. Efficacy was assessed from the percentage reduction in seizure frequency and by retention of treatment. Tolerability was assessed by reports of treatment-emergent effects. Results: Of 532 people enrolled, 512 completed the assessment. Most (431 people, 84%) had a decrease in seizure frequency of at least 50% and 218 became seizure-free. Treatment retention was 96% at one year. VPA was well tolerated and only 47 people reported adverse events which were mostly mild. Only two people discontinued VPA due to side-effects. Conclusion: In this 12-month assessment, VPA had favourable efficacy, few side effects and overall good acceptability. It was also relatively cheap. VPA is, therefore, a suitable alternative to phenobarbital as treatment of convulsive epilepsy in rural areas of China.