Levetiracetam as second-line treatment of status epilepticus – which dose should be applied?
y | 27 jul 2021
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Article Category: research-article
Publicado en línea: 27 jul 2021
Páginas: 7 - 12
Recibido: 21 may 2021
Aceptado: 15 jul 2021
DOI: https://doi.org/10.21307/joepi-2021-001
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© 2021 Johannes Rösche et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Figure 1.
Figure 2.
Studies with administration of 20–25 mg/kg Levetiracetam
| Reference | Criterium of efficacy | LEV group n = | Dosage | Efficacy rate | Efficacy rate of comparator |
|---|---|---|---|---|---|
| Not clearly defined for patients who received LEV after LZP | 10 | 20 mg/kg | 70% | LZP 1 mg/kg 88.9% | |
| No recurrence of seizures after 30 minutes of infusion of study drugs | 50 | 25 mg/kg | 78% | PHT 20 mg/kg 68%, VPA 30 mg/kg 68% | |
| Termination of seizure activity within 30 min after the beginning of the drug infusion | 22 | 20 mg/kg | 59.1% | PHT 20 mg/kg 68% | |
| Seizure control within 24 hours after drug administration | 20 brand LEV/20 generic LEV | 20 mg/kg | 75%/65% | n.a. | |
| No recurrence of seizures after half an hour of infusion of study drugs | 58 | 20-25mg/kg | 74,1% | VPA 20-25 mg/kg 68,3% | |
| Control of convulsive status epilepticus at the end of 15 minutes after completion of study drug infusion (20 minutes) | 32 | 20 mg/kg | 94% | PHT 20 mg/kg 89%, VPA 20 mg/kg 83% | |
| 24 h. | 50 | 25 mg/kg | 78% | VPA 25 mg/kg 92%, PHT 20 mg/kg 88% |
Studies with administration of 40 mg/kg Levetiracetam
| Reference | Criterium of efficacy | LEV group n = | Efficacy rate | Efficacy rate of comparator |
|---|---|---|---|---|
| Median time from randomization to seizure cessation 35 min. | 152 | 70% | PHT 20 mg/kg 64% | |
| Cessation of seizure activity 5 min after completion of infusion of the first trial drug. | 119 | 50% | PHT 20 mg/kg 60% | |
| Cessation of a clinical seizure within 30 minutes after the end of drug adminitstration | 300 | 92,7% | PHT 20 mg/kg 83,3% | |
| No clear time frame before additional “mini bolus” | 52 | 71% | PHT 20 mg/kg 46,1% | |
| Seizure termination within 20 minutes after infusion | 32 | 93,75% | fPHT 20 mg/kg PHT equivalents 69% | |
| 舢median time to seizure cessation 35 min in the LEV group” | 152 | 70% | PHT 20 mg/kg 64% |
Studies with administration of 60 mg/kg Levetiracetam
| Reference | Criterium of efficacy | LEV group n = | Dosage | Efficacy rate | Efficacy rate of comparator |
|---|---|---|---|---|---|
| Absence of clinically apparent seizures with improved consciousness and without additional ASM at 1 h from start of drug infusion. | C: 225 A: 186 E: 51 | 60 mg/kg | C: 52% A: 44% E: 37% | C: VPA 40 mg/kg 52%, fPHT 20 mg/kg PHT eq 49% A: VPA 46%, fPHT 46% E: VPA 47%, fPHT 35% |
Studies with administration of 30 mg/kg Levetiracetam
| Reference | Criterium of efficacy | LEV group n = | Efficacy rate | Efficacy rate of comparator |
|---|---|---|---|---|
| Control of seizures with no recurrence over next 24 h | 22 | 82% | PHT 20 mg/kg 73,3% | |
| Cessation of seizures within 10-20 min following the end of the infusion | 58 | 91,4% | HT 30 mg/kg 93,1% |