Zhai Weiwei, Yu Qiaoling, Wu Huizhen
Graduate School of Hebei Medical University, Shijiazhuang, China.
National Clinical Drug Monitoring Center, Department of Pharmacy, Hebei General Hospital, Shijiazhuang, China.
Front Neurol. 2024 Mar 7;15:1344775. doi: 10.3389/fneur.2024.1344775. eCollection 2024.
This meta-analysis aimed to assess the effectiveness and safety of novel antiepileptic drugs (AEDs) in treating epilepsy in patients with brain tumors (BTRE).
A search was conducted on PubMed, EMBASE, Web of Science, and the Cochrane Library from inception to February 2023, with English language restriction.
In this meta-analysis, 18 clinical trials involving 755 BTRE patients were included to assess the efficacy and safety of novel AEDs in BTRE treatment. At the last follow-up, a ≥50% reduction in seizure frequency was experienced by 72% of patients (random-effects model, 95% CI = 0.64-0.78) using novel AEDs. At the last follow-up, seizure freedom was experienced by 34% of patients (random-effects model, 95% CI = 0.28-0.41) using novel AEDs. The pooled incidence of AEs was found to be 19% (95% CI: 13%-26%), with a withdrawal rate due to adverse effects of only 3%. Comparable efficacy and incidence of adverse effects were observed between lacosamide and perampanel.
This meta-analysis suggests that novel antiepileptic drugs are deemed effective for seizure control in brain tumor patients, particularly when used as adjunctive therapy. Although lacosamide and perampanel received more focus in studies, no significant difference was observed in the efficacy and adverse reactions of these two drugs in seizure control. Further randomized controlled trials are deemed necessary to validate our findings.
本荟萃分析旨在评估新型抗癫痫药物（AEDs）治疗脑肿瘤相关性癫痫（BTRE）患者的有效性和安全性。
检索了从创刊至2023年2月的PubMed、EMBASE、Web of Science和Cochrane图书馆，限定语言为英文。
本荟萃分析纳入了18项涉及755例BTRE患者的临床试验，以评估新型AEDs治疗BTRE的疗效和安全性。在最后一次随访时，使用新型AEDs的患者中有72%（随机效应模型，95%CI = 0.64 - 0.78）癫痫发作频率降低≥50%。在最后一次随访时，使用新型AEDs的患者中有34%（随机效应模型，95%CI = 0.28 - 0.41）实现无癫痫发作。不良事件的合并发生率为19%（95%CI：13% - 26%），因不良反应导致的停药率仅为3%。拉科酰胺和吡仑帕奈在疗效和不良反应发生率方面具有可比性。
本荟萃分析表明，新型抗癫痫药物被认为对控制脑肿瘤患者的癫痫发作有效，尤其是作为辅助治疗时。尽管拉科酰胺和吡仑帕奈在研究中受到更多关注，但这两种药物在控制癫痫发作的疗效和不良反应方面未观察到显著差异。认为有必要进行进一步的随机对照试验来验证我们的发现。
