Should "Historic Control" Epilepsy Monotherapy Trials Be "History"?

of 74%, with stepwise evaluation using a threshold of 68%. RESULTS: The trial was stopped early for positive efficacy after an interim analysis in 125 patients. The full study population included 161 patients, with 148 evaluable for efficacy. The mean time since epilepsy diagnosis was 14 years. Overall, 54.3% (600 mg/d) and 46.9% (150 mg/d) of patients completed 20 weeks of double-blind treatment. Seizure-related exit rate in the 600 mg/d group (27.5%; 95% confidence interval, 17.8%–37.2%) was significantly below the 74% and 68% thresholds (p < 0.001 for both). Eight patients on 600 mg/d and 2 on 150 mg/d were seizure-free throughout pregabalin monotherapy. Pregabalin’s overall safety profile was consistent with prior trials. CONCLUSIONS: Pregabalin monotherapy was safe and efficacious for patients with inadequately controlled partial-onset seizures. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that patients with inadequately controlled partial-onset seizures switched to pregabalin monotherapy have fewer seizurerelated exit events compared with historical controls switched to pseudo-placebo monotherapy.