Original Title: Dieta cetogénica en epilepsia resistente a drogas

Authors' recommendations: No studies assessing survival or quality of life in patients with drug-resistant epilepsy treated with ketogenic diet have been found. Low-quality evidence suggests that the ketogenic diet in children with drug-resistant epilepsy may yield a higher net benefit when compared with standard of care because, in more than 80% of them, the frequency of epileptic seizures decreased by more than 50%. Furthermore, combining commercial ketogenic liquid formulas and ketogenic food preparation would increase seven times adherence to treatment during the first six months in children under three years old. Very low-quality evidence does not allow to draw conclusions on the effectiveness of the ketogenic diet when compared with standard of care in adults with resistant epilepsy. No studies assessing the effectiveness of the different commercial formulas have been found. As regards the clinical practice guidelines found, most of them consider the use of the ketogenic diet in drug-resistant epilepsy as a therapeutic alternative in children. The International League against Epilepsy considers that the commercial ketogenic liquid formula is suitable both in breastfed children and in children fed by enteral catheter, and to improve treatment compliance. However, none of them recommends a specific type of ketogenic diet, as they are all considered similar alternatives. As a general rule, ketogenic diet experts recommend discontinuing the ketogenic diet two years after initiation; however, they suggest to make this decision on a case-by-case basis. Identified Latin-American health funders from Brazil, Chile and from most high-income countries, cover the ketogenic diet as part of drug-resistant epilepsy treatment. This technology is not specifically mentioned in the Mandatory Medical Program or in the Unique Reimbursement System for Disease Management. The economic evaluations found, prior to recent evidence, indicate that it might be a cost-effective technology. Since no local studies have been found and the ketogenic diet in children does not meet all the proposed cost-effectiveness criteria, this dimension is considered uncertain.

Project Status: Completed

Year Published: 2024

URL for published report: https://ets.iecs.org.ar/publication/2190

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Argentina

Organisation Name: Institute for Clinical Effectiveness and Health Policy

Contact Address: Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA

Contact Name: info@iecs.org.ar

Contact Email: info@iecs.org.ar

Copyright: <p>Institute for Clinical Effectiveness and Health Policy (IECS)</p>