Efficacy and Safety of Levetiracetam in Patients With Glioma

Abstract

Objective: To evaluate the efficacy and safety of levetiracetam in the management of epilepsy in patients with glioma. Design: A prospective study in hospitalized patients with a new diagnosis of glioma. Setting: Department of Neurological Sciences and Visions, Spedali Civili of Brescia. Patients: From March 1, 2006, until January 1, 2009, 176 consecutive patients (101 men and 75 women) with a first diagnosis of glioma were enrolled in the study. All patients with a diagnosis of epilepsy were treated with levetiracetam. Main Outcome Measures: Clinical, histological, and magnetic resonance imaging findings were analyzed. Results: Age at the diagnosis of glioma ranged from 22 to 79 years (mean [SD], 57[15] years; median, 59 years). Duration of the disease ranged from 27 days to 2 1?2 years (mean [SD], 13.7[7.8] months; median, 13 months). Eighty-two patients received levetiracetam because of a diagnosis of epilepsy. At the last evaluation (May 1, 2009), 75 of 82 patients (91%) treated with levetiracetam were seizure free; in 2 of these patients, levetiracetam was with-drawn because of intolerable adverse effects. Prompt and long-lasting control of seizures was obtained in 49 of 82 patients (60%) with a dose of levetiracetam that ranged from 1500 to 3000 mg/d, and 9 (11%) of the treated patients needed an increase of levetiracetam dosage to 4000 mg/d to become seizure free. No laboratory abnormalities were observed in patients with concomitant chemotherapy. Conclusion: The results of this study provide good evidence that levetiracetam is efficacious and safe in patients with epilepsy due to glioma. ©2010 American Medical Association. All rights reserved.