1
|
van der Meer PB, Maschio M, Dirven L, Taphoorn MJB, Koekkoek JAF, Coppola A, Maialetti A, Pietrella A, Rigamonti A, Zarabla A, Frigeni B, Salis B, Di. Bonaventura C, Marras CE, Palestini C, Ferlazzo E, Venturelli E, Dainese F, Martella F, Paladin F, Villani F, Capizzi G, Napoleoni L, Stanzani L, Stragapede L, Zummo L, Balducci M, Eoli M, Rizzi M, Vernaleone M, Messina R, Vittorini R, Gasparini S, Ius T, Cianci V, Manfioli V, Mariani V, Capovilla G. First-line levetiracetam versus enzyme-inducing antiseizure medication in glioma patients with epilepsy. Epilepsia 2023; 64:162-169. [PMID: 36380710 PMCID: PMC10100008 DOI: 10.1111/epi.17464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 11/08/2022] [Accepted: 11/14/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This study aimed to directly compare the effectiveness of first-line monotherapy levetiracetam (LEV) versus enzyme-inducing antiseizure medications (EIASMs) in glioma patients. METHODS In this nationwide retrospective observational cohort study, Grade 2-4 glioma patients were included, with a maximum duration of follow-up of 36 months. Primary outcome was antiseizure medication (ASM) treatment failure for any reason, and secondary outcomes were treatment failure due to uncontrolled seizures and due to adverse effects. For estimation of the association between ASM treatment and ASM treatment failure, multivariate cause-specific cox proportional hazard models were estimated, adjusting for potential confounders. RESULTS In the original cohort, a total of 808 brain tumor patients with epilepsy were included, of whom 109 glioma patients were prescribed first-line LEV and 183 glioma patients first-line EIASMs. The EIASM group had a significantly higher risk of treatment failure for any reason compared to LEV (adjusted hazard ratio [aHR] = 1.82, 95% confidence interval [CI] = 1.20-2.75, p = .005). Treatment failure due to uncontrolled seizures did not differ significantly between EIASMs and LEV (aHR = 1.32, 95% CI = .78-2.25, p = .300), but treatment failure due to adverse effects differed significantly (aHR = 4.87, 95% CI = 1.89-12.55, p = .001). SIGNIFICANCE In this study, it was demonstrated that LEV had a significantly better effectiveness (i.e., less ASM treatment failure for any reason or due to adverse effects) compared to EIASMs, supporting the current neuro-oncology guideline recommendations to avoid EIASMs in glioma patients.
Collapse
Affiliation(s)
- Pim B van der Meer
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands
| | - Marta Maschio
- Center for Tumor-Related Epilepsy, Unità Operativa Semplice Dipartimentale Neuro-oncology, Istituto di Ricovero e Cura a Carattere Scientifico Regina Elena National Cancer Institute, Rome, Italy
| | - Linda Dirven
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands.,Department of Neurology, Haaglanden Medical Center, the Hague, the Netherlands
| | - Martin J B Taphoorn
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands
| | - Johan A F Koekkoek
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands.,Department of Neurology, Haaglanden Medical Center, the Hague, the Netherlands
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
2
|
Cione G, Cainelli E, Cappellari A, Di Capua M, Janes A, Pro S, Vittorini R, Manara R, Suppiej A. 36. Bilateral loss of cortical SEPs predict severe MRI lesions in neonatal hypoxic ischemic encephalopathy treated with hypothermia. Clin Neurophysiol 2017. [DOI: 10.1016/j.clinph.2017.09.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
3
|
Manara R, Rocco MC, D'agata L, Cusmai R, Freri E, Giordano L, Darra F, Procopio E, Toldo I, Peruzzi C, Vittorini R, Spalice A, Fusco C, Nosadini M, Longo D, Sartori S. Neuroimaging Changes in Menkes Disease, Part 2. AJNR Am J Neuroradiol 2017; 38:1858-1865. [PMID: 28495940 DOI: 10.3174/ajnr.a5192] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
This is the second part of a retrospective and review MR imaging study aiming to define the frequency rate, timing, imaging features, and evolution of gray matter changes in Menkes disease, a rare multisystem X-linked disorder of copper metabolism characterized by early, severe, and progressive neurologic involvement. According to our analysis, neurodegenerative changes and focal basal ganglia lesions already appear in the early phases of the disease. Subdural collections are less common than generally thought; however, their presence remains important because they might challenge the differential diagnosis with child abuse and might precipitate the clinical deterioration. Anecdotal findings in our large sample seem to provide interesting clues about the protean mechanisms of brain injury in this rare disease and further highlight the broad spectrum of MR imaging findings that might be expected while imaging a child with the suspicion of or a known diagnosis of Menkes disease.
Collapse
Affiliation(s)
- R Manara
- From the Neuroradiology (R.M., M.C.R.), Sezione di Neuroscienze, Medicine and Surgery Department, University of Salerno, Salerno, Italy
| | - M C Rocco
- From the Neuroradiology (R.M., M.C.R.), Sezione di Neuroscienze, Medicine and Surgery Department, University of Salerno, Salerno, Italy
| | - L D'agata
- Department of Neuroscience (L.D.), University of Padova, Padova, Italy
| | - R Cusmai
- Neurology Unit (R.C., D.L.), Bambino Gesù Children's Hospital IRCCS, Roma, Italy
| | - E Freri
- Department of Pediatric Neuroscience (E.F.), Foundation IRCCS, Neurological Institute "C. Besta," Milano, Italy
| | - L Giordano
- Child Neuropsychiatry Unit (L.G.), "Spedali Civili," Brescia, Italy
| | - F Darra
- Child Neuropsychiatry Unit (F.D.), Department of Life and Reproduction Sciences, University of Verona, Verona, Italy
| | - E Procopio
- Metabolic and Neuromuscular Unit (E.P.), Department of Neuroscience, Meyer Children Hospital, Firenze, Italy
| | - I Toldo
- Pediatric Neurology and Neurophysiology Unit (I.T., M.N., S.S.), Department of Woman and Child Health, University Hospital of Padova, Padova, Italy
| | - C Peruzzi
- Child Neuropsychiatry (C.P.), Ospedale Maggiore, Novara, Italy
| | - R Vittorini
- Child Neurology and Psychiatry (R.V.), Department of Pediatrics and Pediatric Specialties, AOU Città della Salute e della Scienza, Torino, Italy
| | - A Spalice
- Children Neurology Division (A.S.), University La Sapienza Roma, Roma, Italy
| | - C Fusco
- Child Neurology and Psychiatry Unit, (C.F.), Department of Pediatrics, ASMN-IRCCS, Reggio Emilia, Italy
| | - M Nosadini
- Pediatric Neurology and Neurophysiology Unit (I.T., M.N., S.S.), Department of Woman and Child Health, University Hospital of Padova, Padova, Italy
| | - D Longo
- Neurology Unit (R.C., D.L.), Bambino Gesù Children's Hospital IRCCS, Roma, Italy
| | - S Sartori
- Pediatric Neurology and Neurophysiology Unit (I.T., M.N., S.S.), Department of Woman and Child Health, University Hospital of Padova, Padova, Italy
| |
Collapse
|
4
|
Gallo MF, Mallucci C, Martelletti P, Romiti A, Vittorini R, Giacovazzo M. [Analysis of the clinical experience with 136 patients with headache treated with lisuride]. Minerva Med 1984; 75:1515-8. [PMID: 6738903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Data on the treatment of 136 patients with essential headache using Lisuride are reported and discussed. The excellent tolerability of the drug and its considerable efficacy even after suspension of treatment are emphasised.
Collapse
|