Prescription preferences of antiepileptic drugs in brain tumor patients: An international survey among EANO members. Issue 2 (21st October 2021)

• Record Type: Journal Article
• Authors: van der Meer, Pim B; Dirven, Linda; van den Bent, Martin J; Preusser, Matthias; Taphoorn, Martin J B; Rudá, Roberta; Koekkoek, Johan A F
• Is Part Of: Neuro-oncology practice. Volume 9:Issue 2(2022)
• Page Start: 105
• Page End: 113
• Publication Date: 2021-10-21
• Subjects: antiepileptic drug -- brain neoplasms -- levetiracetam -- seizures -- valproic acid; Brain -- Tumors -- Periodicals; Brain -- Cancer -- Periodicals; Nervous system -- Cancer -- Periodicals; 616.99481005
• DOI: 10.1093/nop/npab059
• Languages: English
• ISSNs: 2054-2577

Abstract

Abstract: Background: This study aimed at investigating antiepileptic drug (AED) prescription preferences in patients with brain tumor-related epilepsy (BTRE) among the European neuro-oncology community, the considerations that play a role when initiating AED treatment, the organization of care, and practices with regard to AED withdrawal. Methods: A digital survey containing 31 questions about prescription preferences of AEDs was set out among members of the European Association of Neuro-Oncology (EANO). Results: A total of 198 respondents treating patients with BTRE participated of whom 179 completed the entire survey. Levetiracetam was the first choice in patients with BTRE for almost all respondents (90% [162/181]). Levetiracetam was considered the most effective AED in reducing seizure frequency (72% [131/181]) and having the least adverse effects (48% [87/181]). Common alternatives for levetiracetam as equivalent first choice included lacosamide (33% [59/181]), lamotrigine (22% [40/181]), and valproic acid (21% [38/181]). Most crucial factors to choose a specific AED were potential adverse effects (82% [148/181]) and interactions with antitumor treatments (76% [137/181]). In the majority of patients, neuro-oncologists were involved in the treatment of seizures (73% [132/181])). Other relevant findings were that a minority of respondents ever prescribe AEDs in brain tumor patients without epilepsy solely as prophylaxis (29% [53/181]), but a majority routinely considers complete AED withdrawal in BTRE patients who are seizure-free after antitumor treatment (79% [141/179]). Conclusions: Our results show that among European professionals treating patients with BTRE levetiracetam is considered the first choice AED, with the presumed highest efficacy and least adverse effects.