Abstract
Intravenous levetiracetam has been approved for use as an antiepileptic drug, as well as in cases of status epilepticus. There are few reports that detail the clinical data and outcomes associated with this antiepileptic drug, particularly in patients with renal impairment. This was a retrospective analytical study conducted at Khon Kaen University’s Srinagarind Hospital in Thailand. The study period was between January 1, 2010 and December 31, 2014. The inclusion criteria were that patents were over 15 years old, had renal impairment, and had received intravenous levetiracetam treatment. The main clinical outcomes were seizure control and mortality. Clinical outcomes were compared between those with and without status epilepticus. Mortality of patients with status epilepticus were compared in terms of seizure control and order of intravenous levetiracetam treatment. During the study period, there were 247 patients who met the study criteria. The average age of the patients was 58 years with nearly equal sex distribution. Of those, 90 patients (36.4%) had GRFs of less than 15 mL/min/1.73 m2 and 60 patients (24.3%) received intravenous LEVE due to status epilepticus. The seizure control rates in the status epilepticus and non-status epilepticus groups were 36.7% and 88.7%, respectively (P<0.001). The mortality rate did not differ significantly between the two groups (33.3% vs 27.8%; P=0.418). There was no significant overall difference in mortality rate between seizure-controlled and seizure-uncontrolled patients in the status epilepticus group. In the convulsive status epilepticus group, variations in terms of treatment order of intravenous levetiracetam and seizure control resulted in no significant difference in mortality rates (P=0.311). No major side effects were detected in any patients after the intravenous levetiracetam treatment. In conclusion, intravenous levetiracetam treatment was effective and safe in patients with renal impairment.
Highlights
Epilepsy is a common disease in clinical practice
This study aimed to evaluate the clinical use of intravenous levetiracetam in patients with renal impairment
Intravenous levetiracetam was administered as the first-line antiepileptic drug in 165 patients (66.8%) and was given at a dose between 1-2 gm/day in 226 patients (91.5%)
Summary
Epilepsy is a common disease in clinical practice. There were at least 70 million people worldwide suffered from epilepsy in 2010.1 Untreated or uncontrolled epilepsy may lead to several serious conditions or complications including status epilepticus. The administration of antiepileptic drugs is the main method used in the treatment of epilepsy, and is aimed at to controlling seizures, avoiding side effects, and maintaining a good quality of life.[2] Currently, there are at least 155 antiepileptic products registered in Hong Kong, including new antiepileptic drugs such as levetiracetam and zonisamide.[3] The International League Against Epilepsy (ILAE) reported that further clinical studies are required to evaluate the relevant overall outcomes associated with antiepileptic drugs.[4]. This study aimed to evaluate the clinical use of intravenous levetiracetam in patients with renal impairment
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