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Published in: Journal of Experimental & Clinical Cancer Research 1/2009

Open Access 01-12-2009 | Research

The role side effects play in the choice of antiepileptic therapy in brain tumor-related epilepsy: a comparative study on traditional antiepileptic drugs versus oxcarbazepine

Authors: Marta Maschio, Loredana Dinapoli, Antonello Vidiri, Andrea Pace, Alessandra Fabi, Alfredo Pompili, Maria Carmine Carapella, Bruno Jandolo

Published in: Journal of Experimental & Clinical Cancer Research | Issue 1/2009

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Abstract

Background

Seizure control doesn't represent the only challenging goal in patients with brain tumor-related epilepsy. Side effects have often taken precedence for patients' quality of life.

Methods

We performed an observational retrospective study on patients with brain tumor-related epilepsy: 35 who had assumed oxcarbazepine monotherapy and 35 patients who had undergone treatment with traditional antiepileptic drugs. Primary variable of efficacy was the mean seizure frequency per month and safety variables were the drop-out for side effects and total incidence of side effects. We applied the Propensity Score technique to minimize selection bias.

Results

Our results showed a similar efficacy of oxcarbazepine and traditional antiepileptic drugs over time, but the difference in safety and tolerability between the two groups was significant: traditional AEDs caused more side effects, both serious and non serious.

Conclusion

This study highlights the importance of taking into consideration not only seizure control but also the appearance of side effects when choosing antiepileptic drugs in this patients population.
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Literature
1.
go back to reference Vecht CJ, van Breemen M: Optimizing therapy of seizures in patients with brain tumors. Neurology. 2006, 67 (12 Suppl 4): S10-S13.CrossRef Vecht CJ, van Breemen M: Optimizing therapy of seizures in patients with brain tumors. Neurology. 2006, 67 (12 Suppl 4): S10-S13.CrossRef
2.
go back to reference Hildebrand J, Lecaille C, Perennes J, Delattre JY: Epileptic seizures during follow-up of patients treated for primary brain tumors. Neurology. 2005, 65: 212-215. 10.1212/01.wnl.0000168903.09277.8f.CrossRef Hildebrand J, Lecaille C, Perennes J, Delattre JY: Epileptic seizures during follow-up of patients treated for primary brain tumors. Neurology. 2005, 65: 212-215. 10.1212/01.wnl.0000168903.09277.8f.CrossRef
3.
go back to reference Glantz MJ, Cole BF, Forsyth PA, Recht LD, Wen PY, Chamberlain MC, Grossman SA, Cairncross JG: Practice parameter: anticonvulsant prophylaxis in patients with newly diagnosed brain tumors. Neurology. 2000, 54: 1886-1893.CrossRef Glantz MJ, Cole BF, Forsyth PA, Recht LD, Wen PY, Chamberlain MC, Grossman SA, Cairncross JG: Practice parameter: anticonvulsant prophylaxis in patients with newly diagnosed brain tumors. Neurology. 2000, 54: 1886-1893.CrossRef
4.
go back to reference Aguiar D, Pazo R, Durán I, Terrasa J, Arrivi A, Manzano H, Martín J, Rifá J: Toxic epidermal necrolysis in patients receiving anticonvulsants and cranial irradiation: a risk to consider. J Neurooncol. 2004, 66: 345-350. 10.1023/B:NEON.0000014538.31561.bc.CrossRef Aguiar D, Pazo R, Durán I, Terrasa J, Arrivi A, Manzano H, Martín J, Rifá J: Toxic epidermal necrolysis in patients receiving anticonvulsants and cranial irradiation: a risk to consider. J Neurooncol. 2004, 66: 345-350. 10.1023/B:NEON.0000014538.31561.bc.CrossRef
5.
go back to reference Arif H, Buchsbaum R, Weintraub D, Koyfman S, Salas-Humara C, Bazil CW, Resor SR, Hirsch LJ: Comparison and predictors of rash associated with 15 antiepileptic drugs. Neurology. 2007, 68: 1701-1709. 10.1212/01.wnl.0000261917.83337.db.CrossRef Arif H, Buchsbaum R, Weintraub D, Koyfman S, Salas-Humara C, Bazil CW, Resor SR, Hirsch LJ: Comparison and predictors of rash associated with 15 antiepileptic drugs. Neurology. 2007, 68: 1701-1709. 10.1212/01.wnl.0000261917.83337.db.CrossRef
6.
go back to reference Klein M, Engelberts NH, Ploeg van der HM, Kasteleijn-Nolst Trenité DG, Aaronson NK, Taphoorn MJ, Baaijen H, Vandertop WP, Muller M, Postma TJ, Heimans JJ: Epilepsy in low-grade gliomas: the impact on cognitive function and quality of life. Ann Neurol. 2003, 54: 514-520. 10.1002/ana.10712.CrossRef Klein M, Engelberts NH, Ploeg van der HM, Kasteleijn-Nolst Trenité DG, Aaronson NK, Taphoorn MJ, Baaijen H, Vandertop WP, Muller M, Postma TJ, Heimans JJ: Epilepsy in low-grade gliomas: the impact on cognitive function and quality of life. Ann Neurol. 2003, 54: 514-520. 10.1002/ana.10712.CrossRef
7.
go back to reference van Breemen MS, Wilms EB, Vecht CJ: Epilepsy in patients with brain tumours: epidemiology, mechanisms, and management. Lancet Neurol. 2007, 6: 421-430. 10.1016/S1474-4422(07)70103-5.CrossRef van Breemen MS, Wilms EB, Vecht CJ: Epilepsy in patients with brain tumours: epidemiology, mechanisms, and management. Lancet Neurol. 2007, 6: 421-430. 10.1016/S1474-4422(07)70103-5.CrossRef
8.
go back to reference French JA, Kugler AR, Robbins JL, Knapp LE, Garofalo EA: Dose-response trial of pregabalin adjunctive therapy in patients with partial seizures. Neurology. 2003, 60: 1631-1637.CrossRef French JA, Kugler AR, Robbins JL, Knapp LE, Garofalo EA: Dose-response trial of pregabalin adjunctive therapy in patients with partial seizures. Neurology. 2003, 60: 1631-1637.CrossRef
9.
go back to reference Maschio M, Albani F, Baruzzi A, Zarabla A, Dinapoli L, Pace A, Pompili A, Carapella CM, Occhipinti E, Jandolo B: Levetiracetam therapy in patients with brain tumour and epilepsy. J Neurooncol. 2006, 80: 97-100. 10.1007/s11060-006-9162-9.CrossRef Maschio M, Albani F, Baruzzi A, Zarabla A, Dinapoli L, Pace A, Pompili A, Carapella CM, Occhipinti E, Jandolo B: Levetiracetam therapy in patients with brain tumour and epilepsy. J Neurooncol. 2006, 80: 97-100. 10.1007/s11060-006-9162-9.CrossRef
10.
go back to reference Maschio M, Dinapoli L, Zarabla A, Pompili A, Carapella CM, Pace A, Giannarelli D, Occhipinti E, Jandolo B: Outcome and tolerability of topiramate in brain tumor associated epilepsy. J Neurooncol. 2008, 86: 61-70. 10.1007/s11060-007-9430-3.CrossRef Maschio M, Dinapoli L, Zarabla A, Pompili A, Carapella CM, Pace A, Giannarelli D, Occhipinti E, Jandolo B: Outcome and tolerability of topiramate in brain tumor associated epilepsy. J Neurooncol. 2008, 86: 61-70. 10.1007/s11060-007-9430-3.CrossRef
11.
go back to reference Mauro AM, Bomprezzi C, Morresi S, Provinciali L, Formica F, Iacoangeli M, Scerrati M: Prevention of early postoperative seizures in patients with primary brain tumors: preliminary experience with oxcarbazepine. J Neurooncol. 2007, 81: 279-285. 10.1007/s11060-006-9229-7.CrossRef Mauro AM, Bomprezzi C, Morresi S, Provinciali L, Formica F, Iacoangeli M, Scerrati M: Prevention of early postoperative seizures in patients with primary brain tumors: preliminary experience with oxcarbazepine. J Neurooncol. 2007, 81: 279-285. 10.1007/s11060-006-9229-7.CrossRef
12.
go back to reference Newton HB, Goldlust SA, Pearl D: Retrospective analysis of the efficacy and tolerability of levetiracetam in brain tumor patients. J Neurooncol. 2006, 78: 99-102. 10.1007/s11060-005-9070-4.CrossRef Newton HB, Goldlust SA, Pearl D: Retrospective analysis of the efficacy and tolerability of levetiracetam in brain tumor patients. J Neurooncol. 2006, 78: 99-102. 10.1007/s11060-005-9070-4.CrossRef
13.
go back to reference Perry JR, Sawka C: Add-on gabapentin for refractory seizures in patients with brain tumours. Can J Neurol Sci. 1996, 23: 128-131. Perry JR, Sawka C: Add-on gabapentin for refractory seizures in patients with brain tumours. Can J Neurol Sci. 1996, 23: 128-131.
14.
go back to reference Cloughesy TF, Wen PY, Robins HI, Chang SM, Groves MD, Fink KL, Junck L, Schiff D, Abrey L, Gilbert MR, Lieberman F, Kuhn J, DeAngelis LM, Mehta M, Raizer JJ, Yung WK, Aldape K, Wright J, Lamborn KR, Prados MD: Phase II trial of tipifarnib in patients with recurrent malignant glioma either receiving or not receiving enzyme-inducing antiepileptic drugs: a North American Brain Tumor Consortium Study. J Clin Oncol. 2006, 24: 3651-3656. 10.1200/JCO.2006.06.2323.CrossRef Cloughesy TF, Wen PY, Robins HI, Chang SM, Groves MD, Fink KL, Junck L, Schiff D, Abrey L, Gilbert MR, Lieberman F, Kuhn J, DeAngelis LM, Mehta M, Raizer JJ, Yung WK, Aldape K, Wright J, Lamborn KR, Prados MD: Phase II trial of tipifarnib in patients with recurrent malignant glioma either receiving or not receiving enzyme-inducing antiepileptic drugs: a North American Brain Tumor Consortium Study. J Clin Oncol. 2006, 24: 3651-3656. 10.1200/JCO.2006.06.2323.CrossRef
15.
go back to reference Kuhn JG: Influence of anticonvulsants on the metabolism and elimination of irinotecan. A North American Brain Tumor Consortium preliminary report. Oncology. 2002, 16: 33-40. Kuhn JG: Influence of anticonvulsants on the metabolism and elimination of irinotecan. A North American Brain Tumor Consortium preliminary report. Oncology. 2002, 16: 33-40.
16.
go back to reference Oberndorfer S, Piribauer M, Marosi C, Lahrmann H, Hitzenberger P, Grisold W: P450 enzyme inducing and non-enzyme inducing antiepileptics in glioblastoma patients treated with standard chemotherapy. J Neurooncol. 2005, 72: 255-260. 10.1007/s11060-004-2338-2.CrossRef Oberndorfer S, Piribauer M, Marosi C, Lahrmann H, Hitzenberger P, Grisold W: P450 enzyme inducing and non-enzyme inducing antiepileptics in glioblastoma patients treated with standard chemotherapy. J Neurooncol. 2005, 72: 255-260. 10.1007/s11060-004-2338-2.CrossRef
17.
go back to reference Crews KR, Stewart CF, Jones-Wallace D, Thompson SJ, Houghton PJ, Heideman RL, Fouladi M, Bowers DC, Chintagumpala MM, Gajjar A: Altered irinotecan pharmacokinetics in pediatric high-grade glioma patients receiving enzyme-inducing anticonvulsant therapy. Clin Cancer Res. 2002, 8: 2202-2209. Crews KR, Stewart CF, Jones-Wallace D, Thompson SJ, Houghton PJ, Heideman RL, Fouladi M, Bowers DC, Chintagumpala MM, Gajjar A: Altered irinotecan pharmacokinetics in pediatric high-grade glioma patients receiving enzyme-inducing anticonvulsant therapy. Clin Cancer Res. 2002, 8: 2202-2209.
18.
go back to reference Grossman SA, Hochberg F, Fisher J, Chen TL, Kim L, Gregory R, Grochow LB, Piantadosi S: Increased 9-aminocamptothecin dose requirements in patients on anticonvulsants. NABTT CNS Consortium. The New Approaches to Brain Tumor Therapy. Cancer Chemother Pharmacol. 1998, 42: 118-126. 10.1007/s002800050794.CrossRef Grossman SA, Hochberg F, Fisher J, Chen TL, Kim L, Gregory R, Grochow LB, Piantadosi S: Increased 9-aminocamptothecin dose requirements in patients on anticonvulsants. NABTT CNS Consortium. The New Approaches to Brain Tumor Therapy. Cancer Chemother Pharmacol. 1998, 42: 118-126. 10.1007/s002800050794.CrossRef
19.
go back to reference Martinez W, Ingenito A, Blakeslee M, Barkley GL, McCague K, D'Souza J: Efficacy, safety, and tolerability of oxcarbazepine monotherapy. Epilepsy Behav. 2006, 9: 448-456. 10.1016/j.yebeh.2006.04.022.CrossRef Martinez W, Ingenito A, Blakeslee M, Barkley GL, McCague K, D'Souza J: Efficacy, safety, and tolerability of oxcarbazepine monotherapy. Epilepsy Behav. 2006, 9: 448-456. 10.1016/j.yebeh.2006.04.022.CrossRef
20.
go back to reference Baruzzi A, Albani F, Riva R: Oxcarbazepine: pharmacokinetic interactions and their clinical relevance. Epilepsia. 1994, 35 (suppl 3): 14-19. 10.1111/j.1528-1157.1994.tb05939.x.CrossRef Baruzzi A, Albani F, Riva R: Oxcarbazepine: pharmacokinetic interactions and their clinical relevance. Epilepsia. 1994, 35 (suppl 3): 14-19. 10.1111/j.1528-1157.1994.tb05939.x.CrossRef
21.
go back to reference Larkin JG, McKee PJ, Forrest G, Beastall GH, Park BK, Lowrie JI, Lloyd P, Brodie MJ: Lack of enzyme induction with oxcarbazepine (600 mg daily) in healthy subjects. Br J Clin Pharmacol. 1991, 31: 65-71.CrossRef Larkin JG, McKee PJ, Forrest G, Beastall GH, Park BK, Lowrie JI, Lloyd P, Brodie MJ: Lack of enzyme induction with oxcarbazepine (600 mg daily) in healthy subjects. Br J Clin Pharmacol. 1991, 31: 65-71.CrossRef
23.
go back to reference Taillibert S, Laigle-Donadey F, Sanson M: Palliative care in patients with primary brain tumors. Curr Opin Oncol. 2004, 16: 587-592. 10.1097/01.cco.0000142075.75591.02.CrossRef Taillibert S, Laigle-Donadey F, Sanson M: Palliative care in patients with primary brain tumors. Curr Opin Oncol. 2004, 16: 587-592. 10.1097/01.cco.0000142075.75591.02.CrossRef
24.
go back to reference Hildebrand J: Management of epileptic seizures. Curr Opin Oncol. 2004, 16: 314-317. 10.1097/01.cco.0000127720.17558.38.CrossRef Hildebrand J: Management of epileptic seizures. Curr Opin Oncol. 2004, 16: 314-317. 10.1097/01.cco.0000127720.17558.38.CrossRef
25.
go back to reference Zaccara G, Messori A, Cincotta M, Burchini G: Comparison of the efficacy and tolerability of new antiepileptic drugs: what can we learn from long-term studies?. Acta Neurol Scand. 2006, 114: 157-168. 10.1111/j.1600-0404.2006.00705.x.CrossRef Zaccara G, Messori A, Cincotta M, Burchini G: Comparison of the efficacy and tolerability of new antiepileptic drugs: what can we learn from long-term studies?. Acta Neurol Scand. 2006, 114: 157-168. 10.1111/j.1600-0404.2006.00705.x.CrossRef
26.
go back to reference Alvestad S, Lydersen S, Brodtkorb E: Rash from antiepileptic drugs: influence by gender, age, and learning disability. Epilepsia. 2007, 48: 1360-1365. 10.1111/j.1528-1167.2007.01109.x.CrossRef Alvestad S, Lydersen S, Brodtkorb E: Rash from antiepileptic drugs: influence by gender, age, and learning disability. Epilepsia. 2007, 48: 1360-1365. 10.1111/j.1528-1167.2007.01109.x.CrossRef
27.
go back to reference Meyers CA: Neuropsychological deficits in brain tumor patients: Effect of location, chronicity, and treatment. Cancer Bull. 1986, 38: 30-32. Meyers CA: Neuropsychological deficits in brain tumor patients: Effect of location, chronicity, and treatment. Cancer Bull. 1986, 38: 30-32.
28.
go back to reference Meyers CA, Boake C: Neurobehavioral disorders in brain tumor patients: Rehabilitation strategies. Cancer Bull. 1993, 45: 362-364. Meyers CA, Boake C: Neurobehavioral disorders in brain tumor patients: Rehabilitation strategies. Cancer Bull. 1993, 45: 362-364.
29.
go back to reference Brunbech L, Sabers A: Effect of antiepileptic drugs on cognitive function in individuals with epilepsy: a comparative review of newer versus older agents. Drugs. 2002, 62: 593-604. 10.2165/00003495-200262040-00004.CrossRef Brunbech L, Sabers A: Effect of antiepileptic drugs on cognitive function in individuals with epilepsy: a comparative review of newer versus older agents. Drugs. 2002, 62: 593-604. 10.2165/00003495-200262040-00004.CrossRef
30.
go back to reference Villikka K, Kivistö KT, Mäenpää H, Joensuu H, Neuvonen PJ: Cytochrome P450-inducing antiepileptics increase the clearance of vincristine in patients with brain tumors. Clin Pharmacol Ther. 1999, 66: 589-593. Villikka K, Kivistö KT, Mäenpää H, Joensuu H, Neuvonen PJ: Cytochrome P450-inducing antiepileptics increase the clearance of vincristine in patients with brain tumors. Clin Pharmacol Ther. 1999, 66: 589-593.
31.
go back to reference Dogan EA, Usta BE, Bilgen R, Senol Y, Aktekin B: Efficacy, tolerability, and side effects of oxcarbazepine monotherapy: A prospective study in adult and elderly patients with newly diagnosed partial epilepsy. Epilepsy Behav. 2008, 13: 156-161. 10.1016/j.yebeh.2008.02.001.CrossRef Dogan EA, Usta BE, Bilgen R, Senol Y, Aktekin B: Efficacy, tolerability, and side effects of oxcarbazepine monotherapy: A prospective study in adult and elderly patients with newly diagnosed partial epilepsy. Epilepsy Behav. 2008, 13: 156-161. 10.1016/j.yebeh.2008.02.001.CrossRef
32.
go back to reference Brada M, Viviers L, Abson C, Hines F, Britton J, Ashley S, Sardell S, Traish D, Gonsalves A, Wilkins P, Westbury C: Phase II of primary temozolomide chemotherapy in patients with WHO grade II gliomas. Ann Oncol. 2003, 14: 1715-1721. 10.1093/annonc/mdg371.CrossRef Brada M, Viviers L, Abson C, Hines F, Britton J, Ashley S, Sardell S, Traish D, Gonsalves A, Wilkins P, Westbury C: Phase II of primary temozolomide chemotherapy in patients with WHO grade II gliomas. Ann Oncol. 2003, 14: 1715-1721. 10.1093/annonc/mdg371.CrossRef
Metadata
Title
The role side effects play in the choice of antiepileptic therapy in brain tumor-related epilepsy: a comparative study on traditional antiepileptic drugs versus oxcarbazepine
Authors
Marta Maschio
Loredana Dinapoli
Antonello Vidiri
Andrea Pace
Alessandra Fabi
Alfredo Pompili
Maria Carmine Carapella
Bruno Jandolo
Publication date
01-12-2009
Publisher
BioMed Central
Published in
Journal of Experimental & Clinical Cancer Research / Issue 1/2009
Electronic ISSN: 1756-9966
DOI
https://doi.org/10.1186/1756-9966-28-60

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