TY - T1的抗癫痫》的有效性tion Triple Therapy in Patients With Glioma With Refractory Epilepsy JF - Neurology JO - Neurology SP - e1488 LP - e1496 DO - 10.1212/WNL.0000000000206852 VL - 100 IS - 14 AU - Pim B. van der Meer AU - Linda Dirven AU - Marta Fiocco AU - Maaike J. Vos AU - Mathilde C.M. Kouwenhoven AU - Martin J. van den Bent AU - Martin J.B. Taphoorn AU - Johan A.F. Koekkoek Y1 - 2023/04/04 UR - //www.ebmtp.com/content/100/14/e1488.abstract N2 - Background and Objectives Approximately 10% of patients with glioma with epilepsy need antiseizure medication (ASM) triple therapy due to refractory epilepsy. The aim of this study was to evaluate whether levetiracetam combined with valproic acid and clobazam (LEV + VPA + CLB), a frequently prescribed triple therapy, has favorable effectiveness compared with other triple therapy combinations in patients with glioma.Methods This was a multicenter retrospective observational cohort study. The primary outcome was the cumulative incidence of time to treatment failure for any reason, from the start of ASM triple therapy treatment. The secondary outcomes included cumulative incidences of the following: (1) time to treatment failure due to uncontrolled seizures; (2) time to treatment failure due to adverse effects; and (3) time to recurrent seizures. Patients were followed up for a maximum duration of 36 months.Results Of 1,435 patients in the original cohort, 90 patients received ASM triple therapy after second-line ASM treatment failure due to uncontrolled seizures. LEV + VPA + CLB was prescribed to 48% (43/90) and other ASM triple therapy to 52% (47/90) of patients. The cumulative incidence of treatment failure for any reason of LEV + VPA + CLB did not statistically significantly differ from that of other ASM triple therapy combinations (12 months: 47% [95% CI 31%–62%] vs 42% [95% CI 27%–56%], p = 0.892). No statistically significant differences for treatment failure due to uncontrolled seizures (12 months: 12% [95% CI 4%–25%] vs 18% [95% CI 8%–30%], p = 0.445), adverse effects (12 months: 22% [95% CI 11%–36%] vs 15% [95% CI 7%–27%], p = 0.446), or recurrent seizures (1 month: 65% [95% CI 48%–78%] vs 63% [95% CI 47%–75%], p = 0.911) were found.Discussion LEV + VPA + CLB might show equivalent effectiveness compared with other ASM triple therapy combinations in patients with glioma.Classification of Evidence This study provides Class III evidence that for patients with glioma with refractory epilepsy on triple therapy ASMs, LEV + VPA + CLB demonstrated similar effectiveness and tolerability compared with other ASM triple therapy combinations.ASM=antiseizure medication; BTRE=brain tumor–related epilepsy; CLB=clobazam; DDD=defined daily dosage; GABA=gamma aminobutyric acid; LCM=lacosamide; LEV=levetiracetam; PER=perampanel; VPA=valproic acid; WHO=World Health Organization ER -