托吡酯治疗癫痫的现况及前景

Topiramte:present and prospective clinical applications in epilepsy

托吡酯为一种单糖基右旋果糖衍生物,具有多重的抗癫痫作用机制,在动物模型及临床试验中均显示了广谱的抗癫痫疗效。其不仅可有效的添加治疗难治性癫痫,而且可单药替换原有抗癫痫药物治疗非难治性癫痫。近年来,越来越多的临床试验研究发现托吡酯用于单药治疗新诊断癫痫也可取得较好的疗效,且不良反应更少,耐受性更好。同时研究发现托吡酯还有助于控制肥胖、偏头痛等癫痫合并症。本文就托吡酯临床应用于治疗癫痫的现况及前景进行综述。

Topiramate, a derivative of the monosaccharide D-fructose, has shown a wide spectrum of antiepileptic efficacy in both animal models and clinical trials, which appear to be the result of its impacts on most currently known seizure-associated mechanisms. It is not only effectively used as adjunctive therapy in patients with refractory epilepsy, but also used as a substitute for other anti-epilepsy drugs in patients with non- refractory epilepsy. Recently, many clinical trials have displayed that it showed better efficacy and tolerability with less adverse reactions when used as monotherapy in patients with newly diagnosed epilepsy. What is more, it can benefit the control of the comorbidity, such as migraine and obesity. This article reviews its present and prospective clinical applications in epilepsy.