{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T18:05:34Z","timestamp":1781719534686,"version":"3.54.5"},"reference-count":0,"publisher":"Canadian Society of Healthcare-Systems Pharmacy","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CJHP"],"abstract":"<jats:p>Background: Status epilepticus (SE) is a neurologic emergency with potential for substantial mortality and morbidity. Parenteral benzodiazepine is the established first-line treatment but fails to control SE in about one-third of patients. Levetiracetam may be used for SE that is refractory to benzodiazepine therapy.\u00a0\nObjective: To examine, by means of a systematic review, the role of IV levetiracetam for the treatment of SE in adults.\u00a0\nData Sources: MEDLINE, Embase, CENTRAL, and CINAHL databases were searched, from inception to August 18, 2020.\u00a0\nStudy Selection and Data Extraction: Included in this review were prospective randomized controlled trials comparing levetiracetam with another antiepileptic drug, given with or after a benzodiazepine, in adult patients with SE. The primary outcome was cessation of SE. Quality of evidence was assessed with the Cochrane risk-of-bias tool. Characteristics of the included studies were reported using descriptive statistics.\u00a0\nData Synthesis: Five studies compared IV levetiracetam with valproic acid, phenytoin (or its prodrug fosphenytoin), or both. All 5 studies found no statistically significant differences in efficacy or safety end points. There were numerically more cases of hypotension and respiratory failure with phenytoin, and more cases of psychiatric adverse effects (e.g., post-ictal psychosis) with levetiracetam.\u00a0\nConclusions: Available evidence suggests that levetiracetam is as effective as valproic acid or phenytoin for the cessation of SE in adults. Other factors should therefore dictate the choice of antiepileptic drug for patients with SE, such as adverse effect profile, logistics of administration, drug cost, inclusion on hospital formularies, and drug availability.\u00a0\nR\u00c9SUM\u00c9\u00a0\nContexte : L\u2019\u00e9tat de mal \u00e9pileptique (EME) est une urgence neurologique qui s\u2019accompagne d\u2019un potentiel important de mortalit\u00e9 et de morbidit\u00e9. La benzodiaz\u00e9pine parent\u00e9rale est le traitement de premi\u00e8re ligne \u00e9tabli, mais ne parvient pas \u00e0 contr\u00f4ler l\u2019EME chez environ un tiers des patients. Le l\u00e9v\u00e9tirac\u00e9tam peut s\u2019utiliser pour les EME r\u00e9fractaires au traitement par les benzodiaz\u00e9pines.\u00a0\nObjectif : Examiner, au moyen d\u2019une revue syst\u00e9matique, le r\u00f4le du l\u00e9v\u00e9tirac\u00e9tam IV pour le traitement de l\u2019EME chez l\u2019adulte.\u00a0\nSources des donn\u00e9es : Les bases de donn\u00e9es MEDLINE, Embase, CENTRAL et CINAHL ont fait l\u2019objet d\u2019une recherche, depuis leur cr\u00e9ation jusqu\u2019au 18 ao\u00fbt 2020.\u00a0\nS\u00e9lection des \u00e9tudes et extraction des donn\u00e9es : Cette revue comprenait des essais contr\u00f4l\u00e9s randomis\u00e9s prospectifs comparant le l\u00e9v\u00e9tirac\u00e9tam \u00e0 un autre m\u00e9dicament anti\u00e9pileptique, administr\u00e9 avec ou apr\u00e8s une benzodiaz\u00e9pine, chez des patients adultes atteints d\u2019EME. Le crit\u00e8re de jugement principal \u00e9tait l\u2019arr\u00eat de l\u2019EME. La qualit\u00e9 des preuves a \u00e9t\u00e9 \u00e9valu\u00e9e avec l\u2019outil de risque de biais Cochrane. Les caract\u00e9ristiques des \u00e9tudes incluses ont \u00e9t\u00e9 rapport\u00e9es \u00e0 l\u2019aide de statistiques descriptives.\u00a0\nSynth\u00e8se des donn\u00e9es : Cinq \u00e9tudes ont compar\u00e9 le l\u00e9v\u00e9tirac\u00e9tam IV avec l\u2019acide valpro\u00efque, la ph\u00e9nyto\u00efne (ou son prom\u00e9dicament, la fosph\u00e9nyto\u00efne), ou les deux. Les 5 \u00e9tudes n\u2019ont trouv\u00e9 aucune diff\u00e9rence statistiquement significative en termes d\u2019efficacit\u00e9 ou d\u2019innocuit\u00e9. Num\u00e9riquement, les cas d\u2019hypotension et d\u2019insuffisance respiratoire avec la ph\u00e9nyto\u00efne \u00e9taient plus \u00e9lev\u00e9s, et les cas d\u2019effets ind\u00e9sirables psychiatriques (par exemple, psychose post-critique) \u00e9taient plus \u00e9lev\u00e9s avec le l\u00e9v\u00e9tirac\u00e9tam.\u00a0\nConclusions : Les preuves disponibles sugg\u00e8rent que le l\u00e9v\u00e9tirac\u00e9tam est aussi efficace que l\u2019acide valpro\u00efque ou la ph\u00e9nyto\u00efne pour l\u2019arr\u00eat de l\u2019EME chez l\u2019adulte. D\u2019autres facteurs devraient donc dicter le choix du m\u00e9dicament anti\u00e9pileptique pour les patients atteints d\u2019EME, tels que le profil des effets ind\u00e9sirables, la logistique d\u2019administration, le co\u00fbt du m\u00e9dicament, l\u2019inscription sur les formulaires hospitaliers et la disponibilit\u00e9 des m\u00e9dicaments.\u00a0<\/jats:p>","DOI":"10.4212\/cjhp.v75i1.3254","type":"journal-article","created":{"date-parts":[[2022,3,23]],"date-time":"2022-03-23T21:45:51Z","timestamp":1648071951000},"source":"Crossref","is-referenced-by-count":10,"title":["Levetiracetam for Status Epilepticus in Adults: A Systematic Review"],"prefix":"10.4212","volume":"75","author":[{"given":"Carly A","family":"Webb","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Wanbon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica D","family":"Otto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2732","published-online":{"date-parts":[[2022,1,8]]},"container-title":["Canadian Journal of Hospital Pharmacy"],"original-title":[],"link":[{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/3254\/4572","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/3254\/4573","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/3254\/4574","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/3254\/4572","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,23]],"date-time":"2022-03-23T21:45:52Z","timestamp":1648071952000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/view\/3254"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,8]]},"references-count":0,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,1,8]]}},"URL":"https:\/\/doi.org\/10.4212\/cjhp.v75i1.3254","relation":{},"ISSN":["1920-2903","0008-4123"],"issn-type":[{"value":"1920-2903","type":"electronic"},{"value":"0008-4123","type":"print"}],"subject":[],"published":{"date-parts":[[2022,1,8]]}}}