• Search Research Projects
  • Search Researchers
  • How to Use
  1. Back to previous page

Developmental Pharmacology and Therapeutic Drug Monitoring of Antiepileptic Drugs

Research Project

Project/Area Number 09670832
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeSingle-year Grants
Section一般
Research Field Pediatrics
Research InstitutionKITASATO UNIVERSITY

Principal Investigator

MIURA Hisao  Kitasato University School of Medicine, Professor, 医学部, 教授 (60050465)

Co-Investigator(Kenkyū-buntansha) TAKEI Kenji  Kitsato Univ.Sch.of Medicine, Research Associate, 医学部, 助手 (50236410)
SUNAOSHI Wataru  Kitsato Univ.Sch.of Medicine, Assistant Professor, 医学部, 講師 (20171283)
SHIRAI Hiroyuki  Kitsato Univ.Sch.of Medicine, Assistant Professor, 医学部, 講師 (10154353)
SHIMANUKI Kaoru  Kitsato Univ.Sch.of Medicine, Research Associate, 医学部, 助手 (10265697)
IWASAKI Toshiyuki  Kitsato Univ.Sch.of Medicine, Research Associate, 医学部, 助手 (70265627)
細田 のぞみ  北里大学, 医学部, 助手
Project Period (FY) 1997 – 1999
Project Status Completed (Fiscal Year 1999)
Budget Amount *help
¥2,600,000 (Direct Cost: ¥2,600,000)
Fiscal Year 1999: ¥800,000 (Direct Cost: ¥800,000)
Fiscal Year 1998: ¥800,000 (Direct Cost: ¥800,000)
Fiscal Year 1997: ¥1,000,000 (Direct Cost: ¥1,000,000)
KeywordsEpilepsy / Antiepileptic drug / Pharmacokinetics / Developmental pharmacology / Therapeutic drug monitoring / Valproic acid / カルバマゼーピン / バルプロ酸 / てんかん / 薬物体内動態 / 薬物総血中濃度 / 薬物遊離型血中濃度 / 蛋白結合比率 / カルバマゼピン / カルバマゼピン-10,11-エポキサイド / 薬物血中濃度 / ゾニサ・ミド / クロナゼパム
Research Abstract

We investigated the long-term outcome of epilepsy with grand mal seizures on awakening in a prospective randomized study in children who were treated with sodium valproate (VPA) monotherapy.
The patients comprised 194 previously untreated children aged 8 months to 15 years (mean, 8 years 1 month), who had been newly referred to our pediatric seizure clinic. A daily dose of 25-30 mg/kg of VPA was introduced, and the initial maintenance daily dosage of VPA (27.0±3.6mg/kg) gave the plasma levels of 103.1±1 8.2μg/ml.
Of the total 194 patients, seizures were not controlled in 16 by VPA monotherapy, and 58 patients were lost from follow-up during the course of treatment. In 108 out of the remaining 120 patients, VPA monotherapy was continued for a mean of 5 years and 8 months, and then the drug therapy was discontinued. The drug therapy was successfully discontinued in 87, in whom no seizure recurrences were ocurred during the follow-up period 6 months to 15 years (mean, 7 years 4 months) after stopping the therapy. However, in the other 21 patients seizures recurred 2 weeks to 4 years (mean, 7 months) after stopping the therapy. There were no differences in the course of treatment between the cases with seizure recurrences and those without recurrences after discontinuance of the therapy, but the recurrence rate was significantly higher in the patients who were taken ill after the age of 9 (17/43=39.5%). During the course of treatment from childhood to adolescence on the same maintence daily dosage, the plasma concentrations of VPA showed a decrease of about 20%.
The long-term outcome of epileptic children with grand mal seizures on awakening treated with VPA monotherpy is excellent, but the attention should be paid for the recurrence of seizures after stopping therapy in the cases of older patient.

Report

(4 results)
  • 1999 Annual Research Report   Final Research Report Summary
  • 1998 Annual Research Report
  • 1997 Annual Research Report
  • Research Products

    (38 results)

All Other

All Publications (38 results)

  • [Publications] 武井研二: "Clonazepamの併用がzonisamideの血中濃度におよぼす影響(続報)"日本小児臨床薬理学会雑誌. 11. 92-94 (1998)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] 白井宏幸: "小児ならびに思春期年齢患者におけるカルバマゼピンならびにカルバマゼピン-10,11-エホキサイドの遊離型血中濃度に関する研究第1,2編"日本小児科学会雑誌. 102. 1066-1072 (1998)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] 三浦寿男: "抗てんかん薬の発達薬理とTDM"日本小児臨床薬理学会雑誌. 12. 17-23 (1999)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] Miura H: "Developmental and therapeutic pharmacology of Gntiepileptic drugs"Epilepsia. 41(Suppl)(in press). (2000)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] Miura H: "Once-daity close of zonisamide monotherapy in childern with cryptogenic locolization-related epilepsies : clinical effects and pharmacokinetic studies"Epilepsia. 41(Suppl)(in press). (2000)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] 武井研二: "小児期発症特発性全般性大発作てんかんに対するバルプロ酸ナトリラム単剤治療の効果"日本小児科学会雑誌. 104(印刷中). (2000)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] 三浦寿男: "目で見る熱性けいれんの指導管理"トーア総合企画社. 1-32 (1997)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] Sunaoshi, W.: "Effect of concurrent administration of I lamotrigine on the plasma concentrations of carbamazepine and its epoxide metabolite a clinical implication (in Japanese)"J.Jpn.Epi.Soc.. 15(1). 17-23 (1997)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] Abo, K.: "Clonazepam monotherapy in the control of partial seizures in children : a trial with an initial maintenance daily dose of 0.05mg/kg (in Japanese)"J.Jpn.Pediatr.Soc.. 101(5). 934-940 (1997)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] Abo, K.: "Long-term outcome of childhood absence epilepsy treated with clonazepam monotherapy (in Japanese)"J.Jpn.Pediatr.Soc.. 101(5). 941-946 (1997)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] Takei, K.: "Long-term outcome of epilepsy in children with tonic-clonic seizures on awakening treated with valproate monotherapy"Epilepsia. 38 (Suppl. 6). 73 (1997)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] Shirai, H.: "Initial effects and long-term outcome of West syndrome treated with adrenocortico-tropic hormone (ACTH) and clonazepam"Int.Clin.Psychopharmacol.. 13(1). 47-48 (1998)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] Takei, K.: "Effect of concurrent administration of clonazepam on the plasma concentrations of zonisamide (in Japanese)"Jpn.J.Dev.Pharmacol.Ther.. 11(1). 92-94 (1998)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] Shirai, H.: "Free and total plasma concentrations of carbamazepine and carbamazepine-10, 11-epoxide in epileptic patients in childhood and adolescence : free fractions of carbamazepine and carbamazepine-10, 11-epoxide (in Japanese)"J.Jpn.Pediatr.Soc.. 102(10). 1066-1072 (1998)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] Shirai, H.: "Free and total plasma concentrations of carbamazepine and carbamazepine-10, 11-epoxide in epileptic patients in childhood and adolescence : total and free plasma concentration ratios of carbamzepine-10, 11-epoxide to carbamazepine (in Japanese)"J.Jpn.Pediatr.Soc.. 102(10). 1073-1078 (1998)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] Miura, H.: "Developmental pharmacology and therapeutic drug monitoring of antiepileptic drugs (in Japanese)"Jpn.J.Dev.Pharmacol.Ther.. 12(1). 17-23 (1999)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] Miura, H.: "Developmental and therapeutic pharmacology of antiepileptic drugs."Epilepsia. 41 (Suppl.) (in press). (2000)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] Miura, H.: "Once-daily dose of zonisamide monotherapy in children with cryptogenic localization-related epilepsies : clinical effects and pharmacokinetic studies"Epilepsia. 41 (Suppl.) (in press). (2000)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] Takei, K: "Long-term outcome of epilepsy in children with generalized idiopathic grand mal seizures treated with sodium valproate monotherapy (in Japanese)"J.Jpn.Pediatr.Soc.. 104(5) (in press). (2000)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] Shirai H: "Free and total plasma concentrations of carbamazepine and carbamazepine-10,11-epoxide in epileptic patients in childhood and ad"International Clinical Psychopharmacology. 14・1. 59 (1999)

    • Related Report
      1999 Annual Research Report
  • [Publications] 三浦 寿男: "抗てんかん薬の発達薬理とTDM"日本小児臨床薬理学会雑誌. 12・1. 18-25 (1999)

    • Related Report
      1999 Annual Research Report
  • [Publications] 砂押 渉: "抗てんかん薬の相互作用と副作用"小児内科. 31・4. 474-479 (1999)

    • Related Report
      1999 Annual Research Report
  • [Publications] Miura H: "Developmental and therapeutic pharmacology of antieqileptic drugs"Epilepsia. 41(Suppl)(in press). (2000)

    • Related Report
      1999 Annual Research Report
  • [Publications] Miura H: "Once-daily dose of zonisamidemonotherapy in children with cryptogenic localization・Yelatecl epilepsions:clinical effects and ph"Epilepsia. 41(Suppl)(in press). (2000)

    • Related Report
      1999 Annual Research Report
  • [Publications] 武井 研二: "小児期発症特発性全般性大発作てんかんに対するバルプロ酸ナトリウム単剤治療の長期効果"日本小児科学会雑誌. 103・6(掲載予定). (2000)

    • Related Report
      1999 Annual Research Report
  • [Publications] Shirai H: "Initial effects and long-term outcome of West syndrome troated with adrenocorticotropic hormone (ACTH) and clonazepan in combination" International Clinical Psychopharmacology. 13・1. 47-48 (1998)

    • Related Report
      1998 Annual Research Report
  • [Publications] 三浦寿男: "医師の立場からみたTDMの現状と将来 : 小児科領域-抗てんかん薬を中心に-" TDM研究. 15・2. 67-68 (1998)

    • Related Report
      1998 Annual Research Report
  • [Publications] 武井研二: "Clonazepamの併用がzonisamideの血中濃度におよぼす影響(続報)" 日本小児臨床薬理学会雑誌. 11・1. 92-94 (1998)

    • Related Report
      1998 Annual Research Report
  • [Publications] 白井宏幸: "小児ならびに思春期年齢患者におけるカルバマゼピンならびにカルバマゼピン-10,11-エポキサイドの遊離型血中濃度に関する研究 第1編-遊離型血中濃度の比率に関する研究-" 日本小児科学会雑誌. 102・10. 1066-1072 (1998)

    • Related Report
      1998 Annual Research Report
  • [Publications] 白井宏幸: "小児ならびに思春期年齢患者におけるカルバマゼピンならびにカルバマゼピン-10,11-エポキサイドの遊離型血中濃度に関する研究 第2編-カルバマゼピン-10,11-エポキサイド/カルバマゼピンの血中濃度の比率に関する研究-" 日本小児科学会雑誌. 102・10. 1073-1078 (1998)

    • Related Report
      1998 Annual Research Report
  • [Publications] 武井研二: "Acetaminophen生剤の併用がdiazepam坐剤の直腸からの吸収に及ぼす影響-反復投与時の薬物動態学的解析と至適投与設計-" 小児科臨床. 51・11. 2297-2301 (1998)

    • Related Report
      1998 Annual Research Report
  • [Publications] 砂押 渉: "Lamotrigineの併用がcarbamazepineならびにcarbamazepine10,11-epoxideの血中濃度におよぼす影響" てんかん研究. 15・1. 17-23 (1997)

    • Related Report
      1997 Annual Research Report
  • [Publications] 安保賢一: "小児の部分発作に対するクロナゼパム単剤治療の効果" 日本小児科学会雑誌. 101・5. 934-940 (1997)

    • Related Report
      1997 Annual Research Report
  • [Publications] 安保賢一: "小児欠神てんかんに対するクロナゼパム単剤治療の長期効果" 日本小児科学会雑誌. 101・5. 941-946 (1997)

    • Related Report
      1997 Annual Research Report
  • [Publications] 武井研二: "小児の覚醒児大発作てんかんに対するsodiumvalproate単剤治療の効果" 日本小児臨床薬理学会雑誌. 10・1. 92-94 (1997)

    • Related Report
      1997 Annual Research Report
  • [Publications] Takei K: "Long-term outcome of epilepsy in children with tonicclonic soizures on awakening treated with valproate montherapy" Epilepsia. 38(Suppl6). 73- (1997)

    • Related Report
      1997 Annual Research Report
  • [Publications] 三浦寿男: "薬物相互作用:その対策と予測-小児の場合-" TDM研究. 14・1. 5-6 (1997)

    • Related Report
      1997 Annual Research Report
  • [Publications] 三浦寿男: "目で見る熱性けいれんの指導管理" ト-ア総合企画社, 1-32 (1997)

    • Related Report
      1997 Annual Research Report

URL: 

Published: 1997-04-01   Modified: 2016-04-21  

Information User Guide FAQ News Terms of Use Attribution of KAKENHI

Powered by NII kakenhi