Levetiracetam and Phenytoin Compared for Seizure Prophylaxis Following TBI
A new meta-analysis found no evidence to suggest levetiracetam treatment is superior to phenytoin for early or late seizure prophylaxis in patients experiencing seizures following traumatic brain injuries (TBI).
Researchers from China assessed eight studies; one randomized control trial and seven cohort studies, which compared levetiracetam and phenytoin. The studies were identified via a search of the MEDLINE, EMBASE, and Cochrane library database. A total of 1,285 patients were included and the outcomes included early or late seizure prophylaxis and safety.
With regards to early seizure prophylaxis, levetiracetam showed no superiority over phenytoin (RR 1.10, 95% CI, 0.64-1.88); incidence of early seizure was 0.05 (95% CI 0.02-0.08).
With respect to late seizures, three studies that investigated them specifically found no indication of superiority for levetiracetam to phenytoin. Additionally, no differences were found in mortality during hospitalization or after 6 months.
The authors found no difference in superiority of levetiracetam to phenytoin, however they called for further evidence from high-quality studies, citing how none of the findings from their study represented class 1 evidence.
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