Trial reportEpilepsia2013
Lessons from the RAMPART study--and which is the best route of administration of benzodiazepines in status epilepticus.
Trial report in Epilepsia, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 4 syntheses or guidelines pooled it, 65 citations in OpenAlex.
- Management of the first stage of convulsive status epilepticus in adults: a systematic review of current randomised evidence.Journal of neurology · 2022Pooled it
- Pre-hospital and emergency department treatment of convulsive status epilepticus in adults: an evidence synthesis.Health technology assessment (Winchester, England) · 2022Pooled it
- Drug management for acute tonic-clonic convulsions including convulsive status epilepticus in children.The Cochrane database of systematic reviews · 2018Pooled it
- A Common Reference-Based Indirect Comparison Meta-Analysis of Buccal versus Intranasal Midazolam for Early Status Epilepticus.CNS drugs · 2015Pooled it
- Challenges of status epilepticus management in a resource-limited setting: A review.IBRO neuroscience reports · 2024Article
- Treatment of pediatric convulsive status epilepticus.Frontiers in neurology · 2023Review
- [S2k guidelines: status epilepticus in adulthood : Guidelines of the German Society for Neurology].Der Nervenarzt · 2021Review
- Rescue therapies for seizure emergencies: current and future landscape.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2021Review
- Time Is Brain: Acute Control of Repetitive Seizures and Status Epilepticus Using Alternative Routes of Administration of Benzodiazepines.Journal of clinical medicine · 2021Review
- Treatment of acetylcholinesterase inhibitor-induced seizures with polytherapy targeting GABA and glutamate receptors.Neuropharmacology · 2021Article
- Acute administration of diazepam or midazolam minimally alters long-term neuropathological effects in the rat brain following acute intoxication with diisopropylfluorophosphate.European journal of pharmacology · 2020Article
- Autoinjector device for rapid administration of drugs and antidotes in emergency situations and in mass casualty management.The Journal of international medical research · 2020Review
- Midazolam: an essential palliative care drug.Palliative care and social practice · 2020Review
- Intranasal midazolam as first-line inhospital treatment for status epilepticus: a pharmaco-EEG cohort study.Annals of clinical and translational neurology · 2019Article
- Evaluation of first-line anticonvulsants to treat nerve agent-induced seizures and prevent neuropathology in adult and pediatric rats.Neurotoxicology · 2019Article
- Use of Emergency Medication in Adult Patients with Epilepsy: A Multicentre Cohort Study from Germany.CNS drugs · 2018Article
- Practical Management of Epileptic Seizures and Status Epilepticus in Adult Palliative Care Patients.Frontiers in neurology · 2018Review
- Polytherapy as first-line in status epilepticus: should we change our practice? "Time is brain"!Annals of translational medicine · 2016Article
- Pharmacotherapy for Status Epilepticus.Drugs · 2015Review
- Outpatient pharmacotherapy and modes of administration for acute repetitive and prolonged seizures.CNS drugs · 2015Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 4 institutions in 1 country.
Funding
Abstract
Early treatment of prolonged seizures with benzodiazepines given intravenously by paramedics in the prehospital setting had been shown to be associated with improved outcomes, but the comparative efficacy and safety of an intramuscular (IM) route, which is faster and consistently achievable, was previously unknown. RAMPART (the Rapid Anticonvulsant Medication Prior to Arrival Trial) was a double-blind randomized clinical trial to determine if the efficacy of intramuscular (IM) midazolam is noninferior by a margin of 10% to that of intravenous (IV) lorazepam in patients treated by paramedics for status epilepticus (SE). In children and adults with >5 min of convulsions and who are still seizing at paramedic arrival, midazolam administered by IM autoinjector was noninferior to IV lorazepam on the primary efficacy outcome with comparable safety. Patients treated with IM midazolam were more likely to have stopped seizing at emergency department (ED) arrival, without emergency medical services (EMS) rescue therapy, and were less likely to require any hospitalization or admission to an intensive care unit. Lessons from the RAMPART study's findings and potential implications on clinical practice, on the potential role of other routes of administration, on the effect of timing of interventions, and on future clinical trials are discussed.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.