PMID- 33761391
OWN - NLM
STAT- MEDLINE
DCOM- 20210712
LR  - 20210712
IS  - 1532-2688 (Electronic)
IS  - 1059-1311 (Linking)
VI  - 87
DP  - 2021 Apr
TI  - Antiseizure medication in patients with Glioblastoma- a collaborative cohort 
      study.
PG  - 107-113
LID - S1059-1311(21)00088-1 [pii]
LID - 10.1016/j.seizure.2021.03.012 [doi]
AB  - PURPOSE: We investigated, whether epileptic seizures (ES) as presenting symptom 
      in adult patients with GBM are associated with better Overall Survival (OS) 
      compared to ES presenting later during the course of GBM, and efficacy and safety 
      of different antiseizure medications (ASMs). METHODS: Retrospective consecutive 
      cohort study of adults with GBM: 50 from Norway and 50 from Italy. We compared 
      the time to changing ASM treatments. OS was investigated with a Cox regression 
      model adjusted for time dependency. RESULTS: Median follow-up was 17 months from 
      GBM diagnosis. ES were the presenting symptom in 49 patients. All patients 
      received ASM treatment. LEV was the first ASM in the majority of patients and the 
      most effective at one year from the first prescription, (p = 0.004). Occurrence 
      of adverse events (AEs) was similar between LEV and other ASMs (p = 0.47). Poorer 
      OS correlated with older age at GBM diagnosis, country and ASM therapy. A 
      negative impact of ASMs on OS was observed for LEV in a univariate and 
      multivariate analysis, and for VPA (only in multivariate analysis), even when 
      adjusted for O6-methylguanine-DNA-methyltransferase (MGMT) methylation status. 
      Patients with ES as the onset symptom of GBM and patients who had first ES later 
      had similar OS (p = 0.87). CONCLUSION: ES as the GBM debut symptom did not lead 
      to a longer OS. LEV was a more effective ASM compared to other treatments with no 
      differences regarding AEs between LEV and other ASMs. Surprisingly, in our 
      patients LEV and VPA were associated with worse OS than other ASMs. This result 
      should be interpreted with caution due to the retrospective nature of this study 
      along with the many variables which may affect the outcome in this population.
CI  - Copyright (c) 2021. Published by Elsevier Ltd.
FAU - Knudsen-Baas, Kristin M
AU  - Knudsen-Baas KM
AD  - Department of Clinical Medicine, University of Bergen, Bergen, Norway; The 
      National Center for Epilepsy, Norway. Electronic address: kriskn@ous-hf.no.
FAU - Storstein, Anette M
AU  - Storstein AM
AD  - Department of Neurology, Haukeland University Hospital, Bergen, Norway. 
      Electronic address: anette.margrethe.storstein@helse-bergen.no.
FAU - Zarabla, Alessia
AU  - Zarabla A
AD  - Center for Tumor-related Epilepsy, UOSD Neuroncology, Regina Elena National 
      Cancer Institute IRCCS, Rome, Italy. Electronic address: 
      alessiazarabla@libero.it.
FAU - Maialetti, Andrea
AU  - Maialetti A
AD  - Center for Tumor-related Epilepsy, UOSD Neuroncology, Regina Elena National 
      Cancer Institute IRCCS, Rome, Italy. Electronic address: 
      andrea.maialetti@libero.it.
FAU - Giannarelli, Diana
AU  - Giannarelli D
AD  - Biostatistic Unit, Regina Elena National Cancer Institute IRCCS, Rome, Italy. 
      Electronic address: diana.giannarelli@ifo.gov.it.
FAU - Beghi, Ettore
AU  - Beghi E
AD  - Laboratorio Malattie Neurologiche, IRCCS - Istituto "Mario Negri", Milano, Italy. 
      Electronic address: ettore.beghi@marionegri.it.
FAU - Maschio, Marta
AU  - Maschio M
AD  - Center for Tumor-related Epilepsy, UOSD Neuroncology, Regina Elena National 
      Cancer Institute IRCCS, Rome, Italy. Electronic address: 
      Marta.maschio@ifo.gov.it.
LA  - eng
PT  - Journal Article
DEP - 20210315
PL  - England
TA  - Seizure
JT  - Seizure
JID - 9306979
SB  - IM
MH  - Adult
MH  - Aged
MH  - *Brain Neoplasms/complications/drug therapy
MH  - *Glioblastoma/complications/drug therapy
MH  - Humans
MH  - Italy
MH  - Norway
MH  - Prognosis
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Antiseizure medication
OT  - Brain tumor
OT  - Epilepsy
OT  - Glioblastoma
OT  - Glioma
OT  - Overall survival
OT  - Seizures
EDAT- 2021/03/25 06:00
MHDA- 2021/07/13 06:00
CRDT- 2021/03/24 20:15
PHST- 2020/08/25 00:00 [received]
PHST- 2021/03/12 00:00 [revised]
PHST- 2021/03/13 00:00 [accepted]
PHST- 2021/03/25 06:00 [pubmed]
PHST- 2021/07/13 06:00 [medline]
PHST- 2021/03/24 20:15 [entrez]
AID - S1059-1311(21)00088-1 [pii]
AID - 10.1016/j.seizure.2021.03.012 [doi]
PST - ppublish
SO  - Seizure. 2021 Apr;87:107-113. doi: 10.1016/j.seizure.2021.03.012. Epub 2021 Mar 
      15.