title: Levetiracetam for seizure prevention in brain tumor patients: a systematic review.
abstract: Seizures are common complications for patients with brain tumors. No clear evidence exists regarding the use of antiepileptic agents for prophylactic use yet newer agents are being favoured in many clinical settings. The objective of this systematic review was to determine the efficacy of levetiracetam for preventing seizures in patients with brain tumors. A literature search was completed using the databases PubMed (1948 to December 2015), EMBASE (1980 to December 2015), Cochrane Database of Systematic Reviews, and Google Scholar. Studies were included if they reported seizure frequency data pertaining to levetiracetam use in patients with brain tumors as either monotherapy or as an add on agent. The literature search produced 21 articles (3 randomized controlled trials, seven prospective observational studies, and 11 retrospective observational studies). All studies were found to be at high risk of bias. Overall, studies show levetiracetam decreased seizure frequency in brain tumor patients with or without craniotomy. Safety outcomes were also favourable. As such, levetiracetam appears effective for reducing seizures in patients with brain tumors and may be considered a first-line agent. However, there is an urgent need for more high quality prospective data assessing levetiracetam and other antiepileptic drugs in this population.
authors.affiliation: College of Pharmacy, Qatar University, PO Box 2713, Doha, Qatar.
authors.forename: Ziad Ghantous
authors.initials: ZG
authors.lastname: Nasr
authors.affiliation: College of Pharmacy, Qatar University, PO Box 2713, Doha, Qatar.
authors.forename: Bridget
authors.initials: B
authors.lastname: Paravattil
authors.affiliation: College of Pharmacy, Qatar University, PO Box 2713, Doha, Qatar. kjw@qu.edu.qa.
authors.forename: Kyle John
authors.initials: KJ
authors.lastname: Wilby
mesh_terms: D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000150:complications*; D006801:Humans; D000077287:Levetiracetam; D064887:Observational Studies as Topic; D010889:Piracetam / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012640:Seizures / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants; D000077287:Levetiracetam; D010889:Piracetam
keywords: Anticonvulsant; Brain neoplasm; Brain tumor; Levetiracetam; Seizure