Levetiracetam versus phenytoin for seizure prophylaxis in brain injured patients: a systematic review and meta-analysis
| Autor: | Alaa Sayed Mohamed, William Francis Casey, Vipin Kauts, Anis Chaari, Karim Abdelhakim |
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| Rok vydání: | 2017 |
| Předmět: |
Phenytoin
Levetiracetam Pharmaceutical Science Pharmacy Cochrane Library Toxicology law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Seizures law Humans Medicine Pharmacology (medical) In patient 030212 general & internal medicine Randomized Controlled Trials as Topic Pharmacology business.industry Piracetam Brain Injuries Meta-analysis Anesthesia Anticonvulsants Post-Exposure Prophylaxis business 030217 neurology & neurosurgery Systematic search medicine.drug |
| Zdroj: | International Journal of Clinical Pharmacy. 39:998-1003 |
| ISSN: | 2210-7711 2210-7703 |
| Popis: | Background The onset of early and/or late seizures in brain injured patients is associated with worse outcome. So far, phenytoin is the most commonly used antiepileptic drug to prevent seizures in this group of patients. Objective In the current metaanalysis, we aimed to compare the efficacy and safety of phenytoin versus levetiracetam for seizure prophylaxis in brain injured patients. Methods A systematic search was conducted in PubMed and Cochrane Library Database by 2 investigators. Four randomized controlled trials (RCTs) were included (295 patients). Data were extracted and the quality of each RCT was assessed. Results Levetiracetam was found to be more effective than phenytoin in seizure prophylaxis (OR = 0.23; CI 95% [0.09–0.56]; Q test p value = 0.18 and I2 = 38%). A trend toward less serious side effects was also found in patients treated with levetiracetam (OR = 0.27; CI 95% [0.07–1.07]; Q test p value = 0.72 and I2 = 0%). Conclusion Levetiracetam is more effective and safer than phenytoin for seizure prophylaxis in brain injured patients. |
| Databáze: | OpenAIRE |
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