Trial reportAnnals of neurology2018
Randomized trial of lacosamide versus fosphenytoin for nonconvulsive seizures.
Trial report in Annals of neurology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis 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
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 63 citations in OpenAlex.
- Risk assessment of arrhythmias related to three antiseizure medications: a systematic review and single-arm meta-analysis.Frontiers in neurology · 2024Pooled it
- Antiseizure medication dosing and monitoring in the intensive care unit: a practical narrative review.Intensive care medicine · 2026Review
- In-hospital outcomes of lacosamide versus levetiracetam for early adjunctive treatment of status epilepticus: A Nationwide Japanese retrospective cohort study.Epilepsia open · 2026Observational
- Diagnosis, treatment, and outcome prediction of non-convulsive status epilepticus in unconscious patients in intensive care units.Neurological research and practice · 2025Review
- Status epilepticus in older adults: A critical review.Epilepsia · 2025Review
- Treatment of convulsive status epilepticus in Brazil: a review.Arquivos de neuro-psiquiatria · 2025Review
- How many patients do you need? Investigating trial designs for anti-seizure treatment in acute brain injury patients.Annals of clinical and translational neurology · 2024Article
- Sustained effort network for treatment of status epilepticus/European academy of neurology registry on adult refractory status epilepticus (SENSE-II/AROUSE).BMC neurology · 2024Article
- Intravenous push administration of anti-seizure medications.Frontiers in neurology · 2024Review
- Further advances in epilepsy.Journal of neurology · 2023Review
- Nonconvulsive status epilepticus characteristics in glioma patients: a retrospective study.Discover oncology · 2023Article
- Status Epilepticus in Older Adults: Diagnostic and Treatment Considerations.Drugs & aging · 2023Article
- [S2k guidelines: status epilepticus in adulthood : Guidelines of the German Society for Neurology].Der Nervenarzt · 2021Review
- Review
- Seizures and Sepsis: A Narrative Review.Journal of clinical medicine · 2021Review
- Diagnosis and Treatment of Status Epilepticus.Journal of epilepsy research · 2020Review
- A Theoretical Paradigm for Evaluating Risk-Benefit of Status Epilepticus Treatment.Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society · 2020Review
- Status epilepticus - time is brain and treatment considerations.Current opinion in critical care · 2019Review
- Electroencephalographic biomarkers of epilepsy development in patients with acute brain injury: a matched, parallel cohort study.Annals of clinical and translational neurology · 2019Article
- Electroencephalographic seizures in critically ill children: Management and adverse events.Epilepsia · 2019Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
21 authors at 15 institutions in 2 countries.
Funding
Abstract
objectiveThe optimal treatment of nonconvulsive seizures in critically ill patients is uncertain. We evaluated the comparative effectiveness of the antiseizure drugs lacosamide (LCM) and fosphenytoin (fPHT) in this population.
methodsThe TRENdS (Treatment of Recurrent Electrographic Nonconvulsive Seizures) study was a noninferiority, prospective, multicenter, randomized treatment trial of patients diagnosed with nonconvulsive seizures (NCSs) by continuous electroencephalography (cEEG). Treatment was randomized to intravenous (IV) LCM 400mg or IV fPHT 20mg phenytoin equivalents/kg. The primary endpoint was absence of electrographic seizures for 24 hours as determined by 1 blinded EEG reviewer. The frequency with which NCS control was achieved in each arm was compared, and the 90% confidence interval (CI) was determined. Noninferiority of LCM to fPHT was to be concluded if the lower bound of the CI for relative risk was >0.8.
resultsSeventy-four subjects were enrolled (37 LCM, 37 fPHT) between August 21, 2012 and December 20, 2013. The mean age was 63.6 years; 38 were women. Seizures were controlled in 19 of 30 (63.3%) subjects in the LCM arm and 16 of 32 (50%) subjects in the fPHT arm. LCM was noninferior to fPHT (p = 0.02), with a risk ratio of 1.27 (90% CI = 0.88-1.83). Treatment emergent adverse events (TEAEs) were similar in both arms, occurring in 9 of 35 (25.7%) LCM and 9 of 37 (24.3%) fPHT subjects (p = 1.0).
interpretationLCM was noninferior to fPHT in controlling NCS, and TEAEs were comparable. LCM can be considered an alternative to fPHT in the treatment of NCSs detected on cEEG. Ann Neurol 2018;83:1174-1185.
Indexed as
Identifiers
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.