Abstracts

Rationale: Adverse effects (AEs) are a common issue for patients on antiepileptic drug (AED) therapy that can lead to poor quality of life (QoL) and non-adherence to medication. In clinical setting, AEs are not always objectively captured, and this can lead to under-reporting of AEs. This study aims to characterise the AE profile amongst epilepsy patients and to determine if the use of polytherapy is associated with a higher LAEP as compared to monotherapy in an Asian population attending an epilepsy clinic in Singapore. Our secondary objective is to evaluate the relationship between LAEP scores and quality of life. Methods: In this cross-sectional study, we recruited patients (age>21 years) with epilepsy who attended the Epilepsy Clinic in Singapore General Hospital from September 2016 to September 2017.  Patients who do not understand English or Chinese, were unable to provide informed consent or who declined participation were excluded from the study. Demographic, clinical and treatment variables were recorded. The Liverpool Adverse Events Profile (LAEP) questionnaire was used to record the patients' AE burden. QOL was measured using the Quality of Life in Epilepsy Inventory-31 (QOLIE-31) questionnaire for epilepsy patients. Results: Of 132 patients (52% female, mean age: 42.6 ± 13.1 years), a majority (79.5%) were Chinese. Seizures were predominantly generalised (49%) with 39% having partial seizures and 12% with mixed or unknown seizure types. The median number of years since diagnosis of epilepsy was 16 years (IQR 8-30). Seizure freedom has been achieved in the last 3 months for 43.9% (n=58) of the patients. Approximately half of the patients were on monotherapy (51%). Levetiracetam (n=53) was used most frequently followed by carbamazepine (n=47) and valproate (n=43). The median LAEP was 30 (IQR 22-39.25). Only 16.6% (n=22) had a LAEP more than or equal to 45. The most commonly reported LAEP specified AEs are tiredness (48.5%), memory problems (43.9%) and sleepiness (34.8%). Patients on monotherapy had significantly lower total LAEP scores than those on polytherapy (p=0.003). In a subgroup analysis of patients on monotherapy, there was no significant difference in total LAEP scores between patients on 1st generation AEDs and those on 2nd generation AEDs. LAEP scores were negatively correlated with total QOLIE-31 scores (rs =-0.624, p s =-0.648, p s =-0.567, p s =-0.453, p Conclusions: Our study found that our patient population does not appear to have a high adverse effects burden. Polytherapy is associated with higher LAEP scores, which is in turn associated with a  poorer quality of life. This study highlights the potential use of an objective measure for monitoring adverse effects associated with antiepileptic drugs. Funding: None