Login Register Cart 0
Generic placeholder image

CNS & Neurological Disorders - Drug Targets

Editor-in-Chief

ISSN (Print): 1871-5273
ISSN (Online): 1996-3181

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Meta-Analysis

Comparison of Safety and Effectiveness between Levetiracetam and Phenytoin in the Treatment of Pediatric Status Epilepticus: A Meta- Analysis

Author(s): Qasem A. AlMulihi, Fatimah A. AlMuhanna*, Mohammed A. AlMuhanna and Eman A. AlSultan

Volume 22, Issue 5, 2023

Published on: 06 July, 2022

Page: [745 - 751] Pages: 7

DOI: 10.2174/1568007X04666220509215121

open access plus

Abstract

Objective: To evaluate the safety and effectiveness of levetiracetam and phenytoin by evaluating the events of seizure termination and recurrence in children.

Methods: We used the internet databases PubMed, Embase, and Google Scholar to conduct a literature search for the appropriate studies. A meta-analysis was performed to calculate the odds ratio using fixed and random-effects models.

Results: We identified 15 studies that were eligible for the meta-analysis. The incidence of seizure termination within 24 h was 76.9% for levetiracetam and 70.5% for phenytoin. Levetiracetam had a higher number of seizure termination events than phenytoin (P = 0.005, I2 = 66%). The incidence of seizure recurrence within 24 h was 10% for levetiracetam and 15.6% for phenytoin. Phenytoin had a significantly higher number of seizure recurrence events than levetiracetam (P = 0.00007, I2 = 21%).

Conclusion: The efficacy and safety of levetiracetam are superior to that of phenytoin in children with status epilepticus. Large Randomized Controlled Trial studies are needed to confirm the result in children.

Keywords: Levetiracetam, phenytoin, status epilepticus, paediatrics, meta-analysis, children.

« Previous Next »
[1]
Guidelines for epidemiologic studies on epilepsy. Commission on epidemiology and prognosis, international league against epilepsy. Epilepsia 1993; 34(4): 592-6.
[http://dx.doi.org/10.1111/j.1528-1157.1993.tb00433.x] [PMID: 8330566]
[2]
Falco-Walter JJ, Bleck T. Treatment of established status epilepticus. J Clin Med 2016; 5(5): 49.
[http://dx.doi.org/10.3390/jcm5050049] [PMID: 27120626]
[3]
Gurcharran K, Grinspan ZM. The burden of pediatric status epilepticus: Epidemiology, morbidity, mortality, and costs. Seizure 2019; 68: 3-8.
[http://dx.doi.org/10.1016/j.seizure.2018.08.021] [PMID: 30270121]
[4]
Brophy GM, Bell R, Claassen J, et al. Guidelines for the evaluation and management of status epilepticus. Neurocrit Care 2012; 17(1): 3-23.
[http://dx.doi.org/10.1007/s12028-012-9695-z] [PMID: 22528274]
[5]
Glauser T, Shinnar S, Gloss D, et al. Evidence-based guideline: Treatment of convulsive status epilepticus in children and adults: Report of the guideline committee of the american epilepsysociety. Epilepsy Curr 2016; 16(1): 48-61.
[http://dx.doi.org/10.5698/1535-7597-16.1.48] [PMID: 26900382]
[6]
McNamara J, Ed. Pharmacotherapy of Epilepsies. Goodman & Gilman’s: The pharmacological basis of therapeutics. (13th ed.), McGraw-Hill Education 2018.
[7]
Wheless JW, Treiman DM. The role of the newer antiepileptic drugs in the treatment of generalized convulsive status epilepticus. Epilepsia 2008; 49 (Suppl. 9): 74-8.
[http://dx.doi.org/10.1111/j.1528-1167.2008.01929.x] [PMID: 19087120]
[8]
Dalziel SR, Furyk J, Bonisch M, et al. A multicentre randomised controlled trial of levetiracetam versus phenytoin for convulsive status epilepticus in children (protocol): Convulsive status epilepticus paediatric trial (ConSEPT) - a predict study. BMC Pediatr 2017; 17(1): 152.
[http://dx.doi.org/10.1186/s12887-017-0887-8] [PMID: 28641582]
[9]
Moher D, Liberati A, Tetzlaff J, Altman DG. PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Med 2009; 6(7): e1000097.
[http://dx.doi.org/10.1371/journal.pmed.1000097] [PMID: 19621072]
[10]
Higgins , Julian PT. Assessing risk of bias in a randomized trial. In: Cochrane handbook for systematic reviews of interventions. Springer 2019; pp. 205-28.
[11]
Besli GE, Yuksel Karatoprak E, Yilmaz S. Efficacy and safety profile of intravenous levetiracetam versus phenytoin in convulsive status epilepticus and acute repetitive seizures in children. Epilepsy Behav 2020; 111: 107289.
[http://dx.doi.org/10.1016/j.yebeh.2020.107289] [PMID: 32702655]

Rights & Permissions Print Cite
Article Metrics
8
© 2024 Bentham Science Publishers | Privacy Policy