Early discontinuation of antiepileptic drugs is noninferior to late discontinuation in neonates

A new study suggests that stopping antiepileptic drug (AED) therapy early leads to similar outcomes as late discontinuation in neonates with acute symptomatic seizures.

“The optimal duration of AED therapy in neonates with acute symptomatic seizures is not clear”, said Dr Ramesh Konanki of the Rainbow Children’s Hospital and Perinatal Centre in Hyderabad, India. Prospective data are lacking and, in practice, the duration of therapy can vary widely, from 7 days to 6 months after hospital discharge, he noted.

Therefore, Dr Konanki and colleagues conducted a randomized noninferiority study to determine whether early discontinuation of AED treatment (on or within 7 days of discharge) was noninferior to late discontinuation (1-3 months after discharge).

A total of 166 term or late pre-term neonates with acute symptomatic seizures requiring AEDs were randomly assigned to early discontinuation (n=76) or late discontinuation (n=90). The primary endpoint was short-term seizure recurrence (within 4 months after discharge). Secondary endpoints included hospital readmission, developmental delay, and mortality.