The association of patient weight and dose of fosphenytoin, levetiracetam, and valproic acid with treatment success in status epilepticus.
The association of patient weight and dose of fosphenytoin, levetiracetam, and valproic acid with treatment success in status epilepticus.
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作者：
已建立的癫痫持续状态治疗试验是一项关于磷苯妥因、左乙拉西坦和丙戊酸治疗苯二氮卓类难治性癫痫持续状态的盲法比较疗效研究。主要结果是在没有额外的抗惊厥药物的情况下，临床发作停止和反应性增加。以重量为基础的剂量上限为75公斤。因此，体重75公斤的患者接受较低的毫克/公斤剂量。在235名成年人中建立了Logistic回归模型，以确定体重(≤或>；75 kg，≤或>；90 kg)、性别、治疗和体重标准化剂量与主要结果和单纯癫痫停止的关系。≤75 kg组和GT；75 kg组的主要疗效分别为45.1%和42.5%。单因素分析显示，≤75 kg(优势比[OR]=0.9，95%可信区间[CI]=0.5 4~1.5 1)或90 kg(OR=0.85，95%CI=0.42~1.6 6)与≤75 kg或≤90 kg相比，成功的可能性无统计学差异。同样，其他预测因素与主要结果或临床癫痫停止没有显著关联。我们的发现表明，剂量上限为75公斤，可能导致的浓度高于结果所需的浓度。需要包括药物浓度和体重增加的研究来证实这些发现。
The Established Status Epilepticus Treatment Trial was a blinded, comparative-effectiveness study of fosphenytoin, levetiracetam, and valproic acid in benzodiazepine-refractory status epilepticus. The primary outcome was clinical seizure cessation and increased responsiveness without additional anticonvulsant medications. Weight-based dosing was capped at 75 kg. Hence, patients weighing >75 kg received a lower mg/kg dose. Logistic regression models were developed in 235 adults to determine the association of weight (≤ or >75 kg, ≤ or >90 kg), sex, treatment, and weight-normalized dose with the primary outcome and solely seizure cessation. The primary outcome was achieved in 45.1% and 42.5% of those ≤75 kg and >75 kg, respectively. Using univariate analyses, the likelihood of success for those >75 kg (odds ratio [OR] = 0.9, 95% confidence interval [CI] = 0.54–1.51) or >90 kg (OR = 0.85, 95% CI = 0.42–1.66) was not statistically different compared with those ≤75 kg or ≤90 kg, respectively. Similarly, other predictors were not significantly associated with primary outcome or clinical seizure cessation. Our findings suggest that doses, capped at 75 kg, likely resulted in concentrations greater than those needed for outcome. Studies that include drug concentrations and heavier individuals are needed to confirm these findings.
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影响因子：
158.5
作者：
Kapur, Jaideep;Elm, Jordan;Silbergleit, Robert
通讯作者：
Silbergleit, Robert
影响因子：
2.9
作者：
Tanaka, Jun;Kasai, Hidefumi;Shimizu, Kenji;Shimasaki, Shigeki;Kumagai, Yuji
通讯作者：
Kumagai, Yuji
DOI：
10.1111/j.1365-2710.1996.tb00005.x
发表时间：
1996-04-01
影响因子：
2
作者：
Kuranari, M;Chiba, S;Takeyama, M
通讯作者：
Takeyama, M
影响因子：
2.5
作者：
Alzueta, Natalia;Ortega, Ana;Aldaz, Azucena
通讯作者：
Aldaz, Azucena
影响因子：
5.6
作者：
Uges, Joris W. F.;van Huizen, Marc D.;Vecht, Charles J.
通讯作者：
Vecht, Charles J.