11 Dec Comparison Trial of Three Anticonvulsant Medications for Status Epilepticus

MedicalResearch.com Interview with:

Dr. Conwit

Robin Conwit, M.D
Program Director, Division of Clinical Research
NIH: National Institute of Neurological Disorders and Stroke

MedicalResearch.com: What is the background for this study?

Response: Approximately one-third of patients with intractable status epilepticus do not respond to benzodiazepines, often the first line medications given in the emergency department, leaving doctors to decide among three commonly prescribed anti-convulsants.

In this study all of the anti-convulsants were equally effective.

The trial gives doctors a way to clear the air of arguments that one of these drugs works any better than the others, or that any one of them is a lot safer.  It gives doctors a reason to choose a dosing strategy in status epilepticus for levetiracetam, which has otherwise been controversial and non-standard.  

MedicalResearch.com: What should readers take away from your report?

Response: For patients, this study helps them know what they might expect when they continue to seize after benzodiazepines.  They can expect to respond to a single dose of these drugs about half the time.

MedicalResearch.com: What recommendations do you have for future research as a result of this work? 

Response: Research of biomarkers that will predict who will respond best to individual medications would be extremely helpful. 

No disclosures for Dr. Conwit.

Citation:

Randomized Trial of Three Anticonvulsant Medications for Status Epilepticus

Jaideep Kapur, M.B., B.S., Ph.D., Jordan Elm, Ph.D., James M. Chamberlain, M.D., William Barsan, M.D., James Cloyd, Pharm.D., Daniel Lowenstein, M.D., Shlomo Shinnar, M.D., Ph.D., Robin Conwit, M.D., Caitlyn Meinzer, Ph.D., Hannah Cock, M.D., Nathan Fountain, M.D., Jason T. Connor, Ph.D., et al., for the NETT and PECARN Investigators

November 28, 2019
N Engl J Med 2019; 381:2103-2113
DOI: 10.1056/NEJMoa1905795

Last Modified: [last-modified]

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Last Updated on December 11, 2019 by Marie Benz MD FAAD