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Tiagabine as add‐on therapy may be more effective with valproic acid – open label, multicentre study of patients with focal epilepsy

The aim of the current study was to review the efficacy of tiagabine (TGB) as add‐on therapy in patients with drug‐resistant focal epilepsy under normal daily clinical practice, and try to identify those who had improvement. This was an open multicentre study conducted in Poland. A group of 330 patients were analysed. Patients received TGB up to 30–50 mg/day with adjustment within the therapeutic range and titration period. For statistical evaluation chi‐square test and logistic analysis were used. At the 16‐week follow‐up visit, 71.4% patients were reported as responders, i.e. had a 50% or greater decrease in seizure frequency compared with baseline (P < 0.001). One‐third of patients were seizure‐free at 16‐week evaluation (P < 0.001). The beneficial effect of TGB on seizure reduction was most marked in patients with partial seizures (P < 0.001). Patients who used valproic acid (mean dose 1307 mg/day) had 61–85% higher chances for disappearance of seizures or reduction of their number by 50% or more. Patients who used carbamazepine (mean dose 800 mg/day) at a dose 1000 mg or higher mg/day had twice lower chance for reduction of seizures by 50% or more (OR = 0.45; 95 CI 0.25–0.82). There was no statistical impact of sex, age and aetiology on probability of therapeutic effect.