Evidence map›Paper›PMID 34187862›Full record

Trial reportNeurology2021

Efficacy of Home Anticonvulsant Administration for Second-Line Status Epilepticus Treatment.

Rafael Wabl, Samuel W Terman, Maria Kwok, Jordan Elm, James Chamberlain, Robert Silbergleit, Chloe E Hill

Open access · greenAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.8field-weighted citation impact, top 31% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 6 citations in OpenAlex.

  1. Efficacy and Safety of Levetiracetam for Childhood Epilepsies.Medical archives (Sarajevo, Bosnia and Herzegovina) · 2024
    Observational
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Rafael WablFrom the Department of Neurology (R.W.), University of Washington, Seattle; Departments of Neurology (S.W.T., C.E.H.) and Emergency Medicine (R.S.), University of Michigan, Ann Arbor; Department of Emergency Medicine (M.K.), Irving Medical Center, Columbia University, New York, NY; Department of Public Health Sciences (J.E.), Medical University of South Carolina, Charleston; and Division of Emergency Medicine (J.C.), Children's National Medical Center, Washington, DC. rwabl@uw.edu.
Samuel W TermanFrom the Department of Neurology (R.W.), University of Washington, Seattle; Departments of Neurology (S.W.T., C.E.H.) and Emergency Medicine (R.S.), University of Michigan, Ann Arbor; Department of Emergency Medicine (M.K.), Irving Medical Center, Columbia University, New York, NY; Department of Public Health Sciences (J.E.), Medical University of South Carolina, Charleston; and Division of Emergency Medicine (J.C.), Children's National Medical Center, Washington, DC.
Maria KwokFrom the Department of Neurology (R.W.), University of Washington, Seattle; Departments of Neurology (S.W.T., C.E.H.) and Emergency Medicine (R.S.), University of Michigan, Ann Arbor; Department of Emergency Medicine (M.K.), Irving Medical Center, Columbia University, New York, NY; Department of Public Health Sciences (J.E.), Medical University of South Carolina, Charleston; and Division of Emergency Medicine (J.C.), Children's National Medical Center, Washington, DC.
Jordan ElmFrom the Department of Neurology (R.W.), University of Washington, Seattle; Departments of Neurology (S.W.T., C.E.H.) and Emergency Medicine (R.S.), University of Michigan, Ann Arbor; Department of Emergency Medicine (M.K.), Irving Medical Center, Columbia University, New York, NY; Department of Public Health Sciences (J.E.), Medical University of South Carolina, Charleston; and Division of Emergency Medicine (J.C.), Children's National Medical Center, Washington, DC.
James ChamberlainFrom the Department of Neurology (R.W.), University of Washington, Seattle; Departments of Neurology (S.W.T., C.E.H.) and Emergency Medicine (R.S.), University of Michigan, Ann Arbor; Department of Emergency Medicine (M.K.), Irving Medical Center, Columbia University, New York, NY; Department of Public Health Sciences (J.E.), Medical University of South Carolina, Charleston; and Division of Emergency Medicine (J.C.), Children's National Medical Center, Washington, DC.
Robert SilbergleitFrom the Department of Neurology (R.W.), University of Washington, Seattle; Departments of Neurology (S.W.T., C.E.H.) and Emergency Medicine (R.S.), University of Michigan, Ann Arbor; Department of Emergency Medicine (M.K.), Irving Medical Center, Columbia University, New York, NY; Department of Public Health Sciences (J.E.), Medical University of South Carolina, Charleston; and Division of Emergency Medicine (J.C.), Children's National Medical Center, Washington, DC.ORCID 0000-0003-4101-2430
Chloe E HillFrom the Department of Neurology (R.W.), University of Washington, Seattle; Departments of Neurology (S.W.T., C.E.H.) and Emergency Medicine (R.S.), University of Michigan, Ann Arbor; Department of Emergency Medicine (M.K.), Irving Medical Center, Columbia University, New York, NY; Department of Public Health Sciences (J.E.), Medical University of South Carolina, Charleston; and Division of Emergency Medicine (J.C.), Children's National Medical Center, Washington, DC.
Children's National · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo investigate whether receiving a second-line anticonvulsant medication that is part of a patient's home regimen influences outcomes in benzodiazepine-refractory convulsive status epilepticus.

methodsUsing the Established Status Epilepticus Treatment Trial data, allocation to a study drug included in the patient's home anticonvulsant medication regimen was compared to receipt of an alternative second-line study medication. The primary outcome was cessation of clinical seizures with improved consciousness by 60 minutes after study drug initiation. Secondary outcomes were seizure cessation adjudicated from medical records and adverse events. We performed inverse probability of treatment-weighted (IPTW) logistic regressions.

resultsOf 462 patients, 232 (50%) were taking 1-2 of the 3 study medications at home. The primary outcome was observed in 39/89 (44%) patients allocated to their home medication vs 76/143 (53%) allocated to a nonhome medication (IPTW odds ratio [OR] 0.66, 95% confidence interval [CI] 0.39-1.14). The adjudicated outcome occurred in 37/89 (42%) patients vs 82/143 (57%), respectively (IPTW OR 0.52, 95% CI 0.30-0.89). There was no interaction between study levetiracetam and home levetiracetam and there were no differences in adverse events.

conclusionThere was no difference in the primary outcome for patients who received a home medication vs nonhome medication. However, the retrospective evaluation suggested an association between receiving a nonhome medication and seizure cessation. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that for patients with refractory convulsive status epilepticus, use of a home second-line anticonvulsant compared to a nonhome anticonvulsant did not significantly affect the probability of stopping seizures.

Indexed as

Outcome Assessment, Health CareAdolescentAdultAnticonvulsantsBenzodiazepinesChildComparative Effectiveness ResearchDouble-Blind MethodDrug Resistant EpilepsyDrug Therapy, CombinationFemaleHumansLevetiracetamMaleMiddle AgedPhenytoinAnticonvulsantsBenzodiazepinesLevetiracetamPhenytoinValproic Acid

Identifiers

PMID34187862
PMCPMC8377878
OpenAlexW3174032150

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.