Impact of antiepileptic drugs for seizure prophylaxis on short and long-term functional outcomes in patients with acute intracerebral hemorrhage: A meta-analysis and systematic review

Brian Spoelhof, Julian Sanchez-Bautista, Andres Zorrilla-Vaca, Peter W Kaplan, Salia Farrokh, Marek A Mirski, Brin Freund, Lucia Rivera Lara

Research output: Contribution to journalArticle

Abstract

Purpose: The purpose of this analysis is to assess the effect of antiepileptics (AEDs) on seizure prevention and short and long term functional outcomes in patients with acute intracerebral hemorrhage. Method: The meta-analysis was conducted using the PRISMA guidelines. A literature search was performed of the PubMed, the Cochrane Library, and EMBASE databases. Search terms included “Anticonvulsants”, “Intracerebral Hemorrhage”, and related subject headings. Articles were screened and included if they were full-text and in English. Articles that did not perform multivariate regression were not included. Overall effect size was evaluated with forest plots and publication bias was assessed with the Begg's and Egger's tests. Results: A total of 3912 articles were identified during the initial review. After screening, 54 articles remained for full review and 6 articles were included in the final analysis. No significant association between the use of AEDs after ICH and functional outcome (OR 1.53 [95%CI: 0.81–2.88] P = 0.18, I 2 = 81.7%). Only one study evaluated the effect AEDs had in preventing post-ICH seizures. Conclusions: The use of prophylactic AEDs was not associated with improved short and long outcomes after acute ICH. This analysis supports the 2015 AHA/ASA recommendation against prophylactic AEDs (class III; level of evidence b).

Original languageEnglish (US)
Pages (from-to)140-146
Number of pages7
JournalSeizure
Volume69
DOIs
StatePublished - Jul 1 2019

Fingerprint

Cerebral Hemorrhage
Anticonvulsants
Meta-Analysis
Seizures
Publication Bias
PubMed
Libraries
Databases
Guidelines
Forests

Keywords

  • Antiepileptic drugs
  • Clinical trials systematic review/meta-analysis
  • Intracerebral hemorrhage
  • Seizure prophylaxis

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Impact of antiepileptic drugs for seizure prophylaxis on short and long-term functional outcomes in patients with acute intracerebral hemorrhage : A meta-analysis and systematic review. / Spoelhof, Brian; Sanchez-Bautista, Julian; Zorrilla-Vaca, Andres; Kaplan, Peter W; Farrokh, Salia; Mirski, Marek A; Freund, Brin; Rivera Lara, Lucia.

In: Seizure, Vol. 69, 01.07.2019, p. 140-146.

Research output: Contribution to journalArticle

@article{21332c1a422949508346ceb6bec14cd2,
title = "Impact of antiepileptic drugs for seizure prophylaxis on short and long-term functional outcomes in patients with acute intracerebral hemorrhage: A meta-analysis and systematic review",
abstract = "Purpose: The purpose of this analysis is to assess the effect of antiepileptics (AEDs) on seizure prevention and short and long term functional outcomes in patients with acute intracerebral hemorrhage. Method: The meta-analysis was conducted using the PRISMA guidelines. A literature search was performed of the PubMed, the Cochrane Library, and EMBASE databases. Search terms included “Anticonvulsants”, “Intracerebral Hemorrhage”, and related subject headings. Articles were screened and included if they were full-text and in English. Articles that did not perform multivariate regression were not included. Overall effect size was evaluated with forest plots and publication bias was assessed with the Begg's and Egger's tests. Results: A total of 3912 articles were identified during the initial review. After screening, 54 articles remained for full review and 6 articles were included in the final analysis. No significant association between the use of AEDs after ICH and functional outcome (OR 1.53 [95{\%}CI: 0.81–2.88] P = 0.18, I 2 = 81.7{\%}). Only one study evaluated the effect AEDs had in preventing post-ICH seizures. Conclusions: The use of prophylactic AEDs was not associated with improved short and long outcomes after acute ICH. This analysis supports the 2015 AHA/ASA recommendation against prophylactic AEDs (class III; level of evidence b).",
keywords = "Antiepileptic drugs, Clinical trials systematic review/meta-analysis, Intracerebral hemorrhage, Seizure prophylaxis",
author = "Brian Spoelhof and Julian Sanchez-Bautista and Andres Zorrilla-Vaca and Kaplan, {Peter W} and Salia Farrokh and Mirski, {Marek A} and Brin Freund and {Rivera Lara}, Lucia",
year = "2019",
month = "7",
day = "1",
doi = "10.1016/j.seizure.2019.04.017",
language = "English (US)",
volume = "69",
pages = "140--146",
journal = "Seizure : the journal of the British Epilepsy Association",
issn = "1059-1311",
publisher = "W.B. Saunders Ltd",

}

TY - JOUR

T1 - Impact of antiepileptic drugs for seizure prophylaxis on short and long-term functional outcomes in patients with acute intracerebral hemorrhage

T2 - A meta-analysis and systematic review

AU - Spoelhof, Brian

AU - Sanchez-Bautista, Julian

AU - Zorrilla-Vaca, Andres

AU - Kaplan, Peter W

AU - Farrokh, Salia

AU - Mirski, Marek A

AU - Freund, Brin

AU - Rivera Lara, Lucia

PY - 2019/7/1

Y1 - 2019/7/1

N2 - Purpose: The purpose of this analysis is to assess the effect of antiepileptics (AEDs) on seizure prevention and short and long term functional outcomes in patients with acute intracerebral hemorrhage. Method: The meta-analysis was conducted using the PRISMA guidelines. A literature search was performed of the PubMed, the Cochrane Library, and EMBASE databases. Search terms included “Anticonvulsants”, “Intracerebral Hemorrhage”, and related subject headings. Articles were screened and included if they were full-text and in English. Articles that did not perform multivariate regression were not included. Overall effect size was evaluated with forest plots and publication bias was assessed with the Begg's and Egger's tests. Results: A total of 3912 articles were identified during the initial review. After screening, 54 articles remained for full review and 6 articles were included in the final analysis. No significant association between the use of AEDs after ICH and functional outcome (OR 1.53 [95%CI: 0.81–2.88] P = 0.18, I 2 = 81.7%). Only one study evaluated the effect AEDs had in preventing post-ICH seizures. Conclusions: The use of prophylactic AEDs was not associated with improved short and long outcomes after acute ICH. This analysis supports the 2015 AHA/ASA recommendation against prophylactic AEDs (class III; level of evidence b).

AB - Purpose: The purpose of this analysis is to assess the effect of antiepileptics (AEDs) on seizure prevention and short and long term functional outcomes in patients with acute intracerebral hemorrhage. Method: The meta-analysis was conducted using the PRISMA guidelines. A literature search was performed of the PubMed, the Cochrane Library, and EMBASE databases. Search terms included “Anticonvulsants”, “Intracerebral Hemorrhage”, and related subject headings. Articles were screened and included if they were full-text and in English. Articles that did not perform multivariate regression were not included. Overall effect size was evaluated with forest plots and publication bias was assessed with the Begg's and Egger's tests. Results: A total of 3912 articles were identified during the initial review. After screening, 54 articles remained for full review and 6 articles were included in the final analysis. No significant association between the use of AEDs after ICH and functional outcome (OR 1.53 [95%CI: 0.81–2.88] P = 0.18, I 2 = 81.7%). Only one study evaluated the effect AEDs had in preventing post-ICH seizures. Conclusions: The use of prophylactic AEDs was not associated with improved short and long outcomes after acute ICH. This analysis supports the 2015 AHA/ASA recommendation against prophylactic AEDs (class III; level of evidence b).

KW - Antiepileptic drugs

KW - Clinical trials systematic review/meta-analysis

KW - Intracerebral hemorrhage

KW - Seizure prophylaxis

UR - http://www.scopus.com/inward/record.url?scp=85064764359&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85064764359&partnerID=8YFLogxK

U2 - 10.1016/j.seizure.2019.04.017

DO - 10.1016/j.seizure.2019.04.017

M3 - Article

C2 - 31048270

AN - SCOPUS:85064764359

VL - 69

SP - 140

EP - 146

JO - Seizure : the journal of the British Epilepsy Association

JF - Seizure : the journal of the British Epilepsy Association

SN - 1059-1311

ER -