Efficacy and safety of VNS therapy or continued medication management for treatment of adults with drug‑resistant epilepsy: systematic review and meta-analysis.
Batson S, Shankar R, Conry J, Boggs J, Radtke R, Mitchell S, Barion F, Murphy J, Danielson V.
Acta Epileptologica 4, 34 (2022).
https://doi.org/10.1007/s00415-022-10967-6
Hot Off The Press - In January of this year, Batson et al. published a systematic literature review and meta-analysis examining the treatment effects of adjunctive vagus nerve stimulation (#VNS) Therapy for drug-resistant epilepsy (#DRE) in adult patients.
The systematic literature review identified six comparative observational studies and four randomized controlled trials to be included in the #meta-analysis. Inclusion criteria were comparative clinical trials where VNS, in combination with anti-seizure medication, were compared to a relevant comparator group (low-stimulation VNS Therapy, best medical practice, or antiseizure medications, regimen). Outcome parameters, including seizure frequency reduction, seizure freedom rates, discontinuations, the load of antiseizure medications, and serious adverse events, were compared between groups.
Patients treated with VNS therapy showed significantly better odds of becoming #responders, defined as a ≥ 50% reduction in seizure frequency (the odds ratio for achieving ≥ 50%, or ≥ 75%, reduction in seizure frequency, respectively, were 2.27 and 3.56), and were less likely to have an increased antiseizure medications load against comparators (risk ratio: 0.36). The group treated with VNS therapy showed the same odds of discontinuation and serious adverse events as the comparison groups.
In conclusion, this meta-analysis demonstrated that VNS therapy can reduce seizure frequency without increasing the risk of discontinuation and serious adverse events for patients with DRE.