File Download
  Links for fulltext
     (May Require Subscription)
Supplementary

Article: Risk factors for seizures and antiepileptic drug-associated adverse effects in high-grade glioma patients: A multicentre, retrospective study in Hong Kong

TitleRisk factors for seizures and antiepileptic drug-associated adverse effects in high-grade glioma patients: A multicentre, retrospective study in Hong Kong
Authors
KeywordsAdverse effect
Aromatic antiepileptic drug
Glioblastoma multiforme
High-grade glioma
Seizure prophylaxis
Issue Date2015
Citation
Surgical Practice, 2015, v. 19, n. 1, p. 2-8 How to Cite?
AbstractAim: The aim of this present study was to determine the frequency, as well as risk factors, for seizures and antiepileptic drug (AED)-associated adverse effects among high-grade glioma (HGG) patients. Patients and Methods: A multicentre, retrospective study of adult Chinese Hong Kong patients from three neurosurgical centres diagnosed with supratentorial HGG between 1 January 2001 and 31 December 2010 was performed. Results: A total of 198 patients, with a mean age of 55years (range: 18-88) and a mean follow up of 15 months, was recruited. Most suffered from glioblastoma multiforme (GBM) (63 per cent) followed by anaplastic astrocytoma (25 per cent). Median overall survival for patients with GBM was 8months, and 11months for those with grade III gliomas. Prophylactic AED was prescribed in 165 patients (83 per cent), and 64 per cent of patients were continued until end of life or last follow up. A total of 112 patients (57 per cent) experienced seizures at a mean duration of 8months postoperatively (range: 1day-75months). Independent predictors for seizures were a diagnosis of GBM [adjusted odds ratio (OR): 2.33, 95 per cent confidence interval (CI): 1.21-4.52] and adjuvant radiotherapy (adjusted OR: 2.97, 95 per cent CI: 1.49-6.62). One-fifth of patients (21 per cent) experienced AED adverse effects, with idiosyncratic cutaneous reactions and hepatotoxicity most frequently observed. An independent predictor for adverse effects was exposure to aromatic AED, such as phenytoin, carbamazepine and phenobarbital (adjusted OR: 3.32, 95 per cent CI: 1.32-8.40). Conclusions: Antiepileptic drug prescription for primary seizure prophylaxis is both pervasive and prolonged for HGG patients. Seizures occur frequently, but most were delayed and none were life threatening. Judicious prescription of AED is required, especially when a significant proportion of patients experience adverse effects. Patients with a diagnosis of GBM and exposure to radiotherapy are at risk. We suggest, contrary to present practice, that primary seizure prophylaxis be given only during the perioperative period and resumed when they occur. We also recommend avoidance of aromatic AED due to their association with idiosyncratic adverse effects.
Persistent Identifierhttp://hdl.handle.net/10722/324951
ISSN
2023 Impact Factor: 0.3
2023 SCImago Journal Rankings: 0.152
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorWoo, Peter Yat Ming-
dc.contributor.authorChan, Danny Tat Ming-
dc.contributor.authorChan, Kwong Yau-
dc.contributor.authorWong, Wai Kei-
dc.contributor.authorPo, Yin Chung-
dc.contributor.authorKwok, John Ching Kong-
dc.contributor.authorPoon, Wai Sang-
dc.date.accessioned2023-02-27T07:28:30Z-
dc.date.available2023-02-27T07:28:30Z-
dc.date.issued2015-
dc.identifier.citationSurgical Practice, 2015, v. 19, n. 1, p. 2-8-
dc.identifier.issn1744-1625-
dc.identifier.urihttp://hdl.handle.net/10722/324951-
dc.description.abstractAim: The aim of this present study was to determine the frequency, as well as risk factors, for seizures and antiepileptic drug (AED)-associated adverse effects among high-grade glioma (HGG) patients. Patients and Methods: A multicentre, retrospective study of adult Chinese Hong Kong patients from three neurosurgical centres diagnosed with supratentorial HGG between 1 January 2001 and 31 December 2010 was performed. Results: A total of 198 patients, with a mean age of 55years (range: 18-88) and a mean follow up of 15 months, was recruited. Most suffered from glioblastoma multiforme (GBM) (63 per cent) followed by anaplastic astrocytoma (25 per cent). Median overall survival for patients with GBM was 8months, and 11months for those with grade III gliomas. Prophylactic AED was prescribed in 165 patients (83 per cent), and 64 per cent of patients were continued until end of life or last follow up. A total of 112 patients (57 per cent) experienced seizures at a mean duration of 8months postoperatively (range: 1day-75months). Independent predictors for seizures were a diagnosis of GBM [adjusted odds ratio (OR): 2.33, 95 per cent confidence interval (CI): 1.21-4.52] and adjuvant radiotherapy (adjusted OR: 2.97, 95 per cent CI: 1.49-6.62). One-fifth of patients (21 per cent) experienced AED adverse effects, with idiosyncratic cutaneous reactions and hepatotoxicity most frequently observed. An independent predictor for adverse effects was exposure to aromatic AED, such as phenytoin, carbamazepine and phenobarbital (adjusted OR: 3.32, 95 per cent CI: 1.32-8.40). Conclusions: Antiepileptic drug prescription for primary seizure prophylaxis is both pervasive and prolonged for HGG patients. Seizures occur frequently, but most were delayed and none were life threatening. Judicious prescription of AED is required, especially when a significant proportion of patients experience adverse effects. Patients with a diagnosis of GBM and exposure to radiotherapy are at risk. We suggest, contrary to present practice, that primary seizure prophylaxis be given only during the perioperative period and resumed when they occur. We also recommend avoidance of aromatic AED due to their association with idiosyncratic adverse effects.-
dc.languageeng-
dc.relation.ispartofSurgical Practice-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectAdverse effect-
dc.subjectAromatic antiepileptic drug-
dc.subjectGlioblastoma multiforme-
dc.subjectHigh-grade glioma-
dc.subjectSeizure prophylaxis-
dc.titleRisk factors for seizures and antiepileptic drug-associated adverse effects in high-grade glioma patients: A multicentre, retrospective study in Hong Kong-
dc.typeArticle-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1111/1744-1633.12102-
dc.identifier.pmid26097495-
dc.identifier.pmcidPMC4467242-
dc.identifier.scopuseid_2-s2.0-84920913086-
dc.identifier.volume19-
dc.identifier.issue1-
dc.identifier.spage2-
dc.identifier.epage8-
dc.identifier.eissn1744-1633-
dc.identifier.isiWOS:000359843300002-

Export via OAI-PMH Interface in XML Formats


OR


Export to Other Non-XML Formats