NCMP-08 - The effectiveness of antiseizure medication tripletherapy in glioma patients with refractory epilepsy: a multicenter observational cohort study

Friday, November 18, 2022

7:30 PM – 9:30 PM ET

Location: West/Central Hall

Author(s)

Pim B. van der Meer, MD

Leiden University Medical Center
Leiden, Netherlands

Author(s)

LD

Linda Dirven, PhD

Leiden University Medical Center
Leiden, Netherlands
MF

Marta Fiocco, PhD

Leiden University
Leiden, Netherlands
MV

Maaike J. Vos, PhD

Haaglanden Medical Center
The Hague, Netherlands
MK

Mathilde Kouwenhoven, MD PhD

Amsterdam University Medical Centers
Amsterdam, Netherlands
Martin J. van den Bent, M.D.

Erasmus MC Cancer Institute
Rotterdam, Netherlands

Poster Presenter(s)

Martin J. Taphoorn, MD PhD

Leiden University Medical Center
Leiden, Netherlands

Author(s)

JK

Johan A. Koekkoek, PhD

Haaglanden Medical Center
The Hague, Netherlands

Background: About 10% of glioma patients with epilepsy need antiseizure medication (ASM) tripletherapy due to refractory epilepsy. This study aimed to determine whether levetiracetam combined with valproic acid and clobazam (LEV+VPA+CLB), a commonly prescribed tripletherapy, has favorable effectiveness compared to other tripletherapy combinations in glioma patients.

Methods: In this multicenter retrospective observational cohort study, the primary outcome was to estimate the cumulative incidence of treatment failure for any reason, from initiation of ASM tripletherapy. Secondary outcomes included cumulative incidences of: 1) treatment failure due to uncontrolled seizures; 2) treatment failure due to adverse effects; and 3) recurrent seizure. Maximum duration of follow-up was 36 months.

Results: Out of n=1435 patients in the original cohort, n=90 patients received ASM tripletherapy after second-line ASM treatment failure due to uncontrolled seizures. LEV+VPA+CLB was prescribed to 48% (43/90) and other ASM tripletherapy to 52% (47/90) patients. The cumulative incidence of treatment failure for any reason of LEV+VPA+CLB did not significantly differ from other tripletherapy (12 months: 47% [95%CI, 31-62%] versus 42% [95%CI, 27-56%], p=0.892). No statistical significant differences for treatment failure due to uncontrolled seizures (12 months: 12% [95%CI, 4-25%] versus 18% [95%CI, 8-30%], p=0.445), due to adverse effects (12 months: 22% [95%CI, 11-36%] versus 15% [95%CI, 7-27%], p=0.446), or recurrent seizure (1 month: 65% [95%CI, 48-78%] versus 63% [95%CI, 47-75%], p=0.911) were found.

Conclusions: LEV+VPA+CLB showed equivalent effectiveness compared to other ASM tripletherapy combinations in glioma patients.