Comparison of treatment guidelines vs real-world observations: India

An electronic medical record-based nationwide retrospective cohort study about patients (n=6318) diagnosed with epilepsy and those who had at least one anti-epileptic medication between January 2001 and December 2019. India’s first such study provides a detailed epidemiological profile, associated comorbidities, and risks of epilepsy. The factors accessed were the patients’ location, age and gender. The major co-morbidities were hypertension, dyslipidemia, diabetes and depression followed by hypothyroidism, stroke/CVA, migraine, anxiety and head injury. The types of epilepsy are focal epilepsy, generalized epilepsy, general and focal, and others. Patients who underwent a change in AED, clobazam was the most prescribed switch/add-on agent. Levetiracetam was followed by sodium valproate as most prescribed monotherapy in PWE at first visit. Although levetiracetam was the most prescribed AED followed by sodium valproate, SANAD trial recommends sodium valproate as the first-line therapy for new generalized PWE.