Observational studyNeurocritical care2025
Levetiracetam Dosing Optimization in Neurocritical Care Population: Neuro-ARC Study.
Observational study in Neurocritical care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 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
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Guidelines for Seizure Prophylaxis in Patients with Aneurysmal Subarachnoid Hemorrhage: A Statement for Healthcare Professionals from the Neurocritical Care Society.Neurocritical care · 2026Guideline
- Antiseizure medication dosing and monitoring in the intensive care unit: a practical narrative review.Intensive care medicine · 2026Review
- Management of antimicrobial therapy in culture-negative post-neurosurgical meningitis caused by augmented renal clearance.IDCases · 2026Article
- Clozapine Drug-Drug Interactions and Individualized Dosing in Bipolar Disorder: A Model-Informed Precision Dosing Approach.Drug design, development and therapy · 2025Article
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.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLevetiracetam, a first-line antiseizure medication, is primarily eliminated through the kidneys, with approximately 66% renal elimination. Consequently, its pharmacokinetics are significantly influenced by kidney function. Augmented renal clearance (ARC), a condition characterized by renal hyperfiltration, is frequently observed in critical care settings and can profoundly impact the disposition of renally eliminated drugs such as levetiracetam. Our objectives were to characterize levetiracetam pharmacokinetics in neurocritical care patients, identify covariates significantly influencing drug clearance, and provide clinicians with optimal dosage recommendations in those with and without ARC.
methodsThis was a multicenter, prospective, observational study involving patients admitted to the participating centers with life-threatening neurological illnesses. Each participant had up to four plasma samples collected, and the samples were analyzed using a validated high-performance liquid chromatography method. The creatinine clearance (CL
resultsOur study included 50 patients, with 35 patients (70%) experiencing ARC. Trough levetiracetam levels were significantly lower in the ARC group compared with the no-ARC group (median [interquartile range] 4.4 [11.5] vs. 11.8 [19] mg/L, p value = 0.039, respectively). Population pharmacokinetic modeling showed levetiracetam clearance at 4.6 ± 2.97 L/h and volume of distribution at 0.56 ± 0.63 L/kg, following a one-compartment model. The mCL
conclusionsAugmented renal clearance significantly impacts the pharmacokinetics of levetiracetam by enhancing clearance. Dosing simulations revealed the inadequacy of the initial 500 mg BID regimen, indicating a minimum dosage of 1500 mg BID is necessary for patients experiencing ARC to achieve reference range concentrations.
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Identifiers
40908416What 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.