International veterinary epilepsy task force consensus proposal: outcome of therapeutic interventions in canine and feline epilepsy

Heidrun Potschka, Andrea Fischer, Wolfgang Löscher, Ned Patterson, Sofie Bhatti, Mette Berendt, Luisa De Risio, Robyn Farquhar, Sam Long, Paul Mandigers, Kaspar Matiasek, Karen Muñana, Akos Pakozdy, Jacques Penderis, Simon Platt, Michael Podell, Clare Rusbridge, Veronika Stein, Andrea Tipold, Holger A Volk

Common criteria for the diagnosis of drug resistance and the assessment of outcome are needed urgently as a prerequisite for standardized evaluation and reporting of individual therapeutic responses in canine epilepsy. Thus, we provide a proposal for the definition of drug resistance and partial therapeutic success in canine patients with epilepsy. This consensus statement also suggests a list of factors and aspects of outcome, which should be considered in addition to the impact on seizures. Moreover, these expert recommendations discuss criteria which determine the validity and informative value of a therapeutic trial in an individual patient and also suggest the application of individual outcome criteria. Agreement on common guidelines does not only render a basis for future optimization of individual patient management, but is also a presupposition for the design and implementation of clinical studies with highly standardized inclusion and exclusion criteria. Respective standardization will improve the comparability of findings from different studies and renders an improved basis for multicenter studies. Therefore, this proposal provides an in-depth discussion of the implications of outcome criteria for clinical studies. In particular ethical aspects and the different options for study design and application of individual patient-centered outcome criteria are considered.