Observational studyEpilepsia2021
First-line antiepileptic drug treatment in glioma patients with epilepsy: Levetiracetam vs valproic acid.
Observational study in Epilepsia, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 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
46 citing papers in PubMed, 4 syntheses or guidelines pooled it, 72 citations in OpenAlex.
- Efficacy and safety of levetiracetam in preventing postoperative seizures in adult patients with brain tumors: a meta-analysis.Frontiers in neurology · 2025Pooled it
- Prevalence and risk factors of early postoperative seizures in patients with glioma: a systematic review and meta-analysis.Frontiers in neurology · 2024Pooled it
- Palliative care and end-of-life care in adults with malignant brain tumors.Neuro-oncology · 2023Pooled it
- Effects of Levetiracetam on the Serum C-Reactive Protein in Children With Epilepsy: A Meta-Analysis.Frontiers in pharmacology · 2022Pooled it
- Seizure prophylaxis in glioma surgery (SPRING): A multi-center, unblinded, randomized trial.Neuro-oncology practice · 2026Article
- The predictive value of serum neurofilament light chain combined with inflammatory biomarkers for post-surgical epilepsy after brain tumor resection: a retrospective diagnostic study.Journal of neuro-oncology · 2026Article
- Review of glioblastoma and systemic comorbidities.Frontiers in oncology · 2026Review
- Voltammmetric Assessment and Examination of the Interactions between Levetiracetam and DNA: Experimental Research, Molecular Docking, and Modeling Studies.ChemistryOpen · 2025Article
- State of the art: glioma-associated epilepsy-bridging tumor biology and epileptogenesis.Neurological research and practice · 2025Review
- Micronutrient antioxidant supplementation alleviates valproic acid-induced oxidative stress and male infertility via the NRF2/HO-1 pathway.Redox biology · 2025Article
- The molecular landscape of glioblastoma-associated epilepsy.Journal of molecular medicine (Berlin, Germany) · 2025Review
- Antiseizure medication choice in diffuse glioma: A single-center population-based experience.Epilepsia open · 2025Article
- Seizure outcomes in patients with brain metastases and epilepsy: a systematic review on the efficacy of antitumor treatment and antiseizure medication.Neuro-oncology practice · 2025Review
- Long-Term Follow-Up Results of Antiseizure Medication Withdrawal in Grade 2 and 3 Glioma Patients: A Prospective Observational Study.Neurology · 2025Observational
- Symptom management in isocitrate dehydrogenase mutant glioma.Neuro-oncology practice · 2025Review
- Levetiracetam and valproic acid in glioma: antiseizure and potential antineoplastic effects.Future oncology (London, England) · 2025Review
- Cenobamate reduces epileptiform activity in theFrontiers in neuroscience · 2025Article
- The role of a multidisciplinary clinic for management of patients with IDH mutant gliomas.Frontiers in oncology · 2025Article
- Epilepsy in Patients with Gliomas.Neurologia medico-chirurgica · 2024Review
- Effects of Levetiracetam and Lacosamide on survival and seizure control in IDH-wild type glioblastoma during temozolomide plus radiation adjuvant therapy.Brain & spine · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThis study aimed at estimating the cumulative incidence of antiepileptic drug (AED) treatment failure of first-line monotherapy levetiracetam vs valproic acid in glioma patients with epilepsy.
methodsIn this retrospective observational study, a competing risks model was used to estimate the cumulative incidence of treatment failure, from AED treatment initiation, for the two AEDs with death as a competing event. Patients were matched on baseline covariates potentially related to treatment assignment and outcomes of interest according to the nearest neighbor propensity score matching technique. Maximum duration of follow-up was 36 months.
resultsIn total, 776 patients using levetiracetam and 659 using valproic acid were identified. Matching resulted in two equal groups of 429 patients, with similar covariate distribution. The cumulative incidence of treatment failure for any reason was significantly lower for levetiracetam compared to valproic acid (12 months: 33% [95% confidence interval (CI) 29%-38%] vs 50% [95% CI 45%-55%]; P < .001). When looking at specific reasons of treatment failure, treatment failure due to uncontrolled seizures was significantly lower for levetiracetam compared to valproic acid (12 months: 16% [95% CI 12%-19%] vs 28% [95% CI 23%-32%]; P < 0.001), but no differences were found for treatment failure due to adverse effects (12 months: 14% [95% CI 11%-18%] vs 15% [95% CI 11%-18%]; P = .636). SIGNIFICANCE: Our results suggest that levetiracetam may have favorable efficacy compared to valproic acid, whereas level of toxicity seems similar. Therefore, levetiracetam seems to be the preferred choice for first-line AED treatment in patients with glioma.
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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.