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Abstract：
When monotherapy used alone or sequentially fails to achieve seizure control, a trial of combination therapy may be considered.
To define optimal criteria to guide choice of an antiseizure medication (ASM) for use as first add-on.
A standardized Delphi procedure was applied to produce a list of consensus statements. First, an Expert Board consisting of 5 epileptologists agreed on a set of 46 statements relevant to the objective. The statements were then finalized through an iterative process by a Delphi Panel of 84 Italian pediatric and adult neurologists with expertise in the management of epilepsy. Panel members provided anonymous ratings of their level of agreement with each statement on a 9-point Likert scale.
Consensus, defined as agreement by at least 80% of Panel members, was reached for 36 statements. Medication-related factors considered to be important for drug selection included efficacy, tolerability and safety, interaction potential, mechanism of action, and ease of use. The need to optimize adherence and to tailor drug selection to individual characteristics was emphasized.
Choice of an ASM for first add-on requires consideration of many factors, many of which also apply to choose initial treatment. Factors more specifically relevant to add-on use include drug interaction potential and the preference for an ASM with a different mechanism of action.
To define optimal criteria to guide choice of an antiseizure medication (ASM) for use as first add-on.
A standardized Delphi procedure was applied to produce a list of consensus statements. First, an Expert Board consisting of 5 epileptologists agreed on a set of 46 statements relevant to the objective. The statements were then finalized through an iterative process by a Delphi Panel of 84 Italian pediatric and adult neurologists with expertise in the management of epilepsy. Panel members provided anonymous ratings of their level of agreement with each statement on a 9-point Likert scale.
Consensus, defined as agreement by at least 80% of Panel members, was reached for 36 statements. Medication-related factors considered to be important for drug selection included efficacy, tolerability and safety, interaction potential, mechanism of action, and ease of use. The need to optimize adherence and to tailor drug selection to individual characteristics was emphasized.
Choice of an ASM for first add-on requires consideration of many factors, many of which also apply to choose initial treatment. Factors more specifically relevant to add-on use include drug interaction potential and the preference for an ASM with a different mechanism of action.
摘要：
当单独或依次使用单一疗法无法控制癫痫发作时，可以考虑联合治疗的试验.
定义最佳标准，以指导选择抗癫痫药物（ASM）作为第一附加药物。
应用了标准化的Delphi程序来生成共识声明列表。首先,由5名癫痫学家组成的专家委员会就与该目标相关的46项声明达成了一致。然后，由具有癫痫治疗专业知识的84名意大利儿科和成人神经科医生组成的Delphi小组通过迭代过程最终确定了这些陈述。小组成员以9分的李克特量表对他们的同意程度进行了匿名评级。
共识,定义为至少80%的小组成员同意，达到36个陈述。被认为对药物选择重要的药物相关因素包括疗效，耐受性和安全性，相互作用潜力，作用机制,和易用性。强调了优化依从性和根据个体特征定制药物选择的必要性。
选择第一个附加组件的ASM需要考虑许多因素，其中许多也适用于选择初始治疗。与附加使用更具体相关的因素包括药物相互作用潜力和对具有不同作用机制的ASM的偏好。
定义最佳标准，以指导选择抗癫痫药物（ASM）作为第一附加药物。
应用了标准化的Delphi程序来生成共识声明列表。首先,由5名癫痫学家组成的专家委员会就与该目标相关的46项声明达成了一致。然后，由具有癫痫治疗专业知识的84名意大利儿科和成人神经科医生组成的Delphi小组通过迭代过程最终确定了这些陈述。小组成员以9分的李克特量表对他们的同意程度进行了匿名评级。
共识,定义为至少80%的小组成员同意，达到36个陈述。被认为对药物选择重要的药物相关因素包括疗效，耐受性和安全性，相互作用潜力，作用机制,和易用性。强调了优化依从性和根据个体特征定制药物选择的必要性。
选择第一个附加组件的ASM需要考虑许多因素，其中许多也适用于选择初始治疗。与附加使用更具体相关的因素包括药物相互作用潜力和对具有不同作用机制的ASM的偏好。
