Seizure Prophylaxis With Levetiracetam in Aneurysmal Subarachnoid Hemorrhage - Pilot Study

NCT ID: NCT01935908

Last Updated: 2017-11-01

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

WITHDRAWN

Clinical Phase

PHASE4

Study Classification

INTERVENTIONAL

Study Start Date

2013-05-31

Study Completion Date

2013-05-31

Brief Summary

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The purpose of this study is to determine the feasibility of prospectively enrolling and randomizing patients with aneurysmal subarachnoid hemorrhage (aSAH) to receive levetiracetam or not to receive levetiracetam, and documenting in-hospital and follow-up clinical variables.

Detailed Description

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Conditions

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Subarachnoid Hemorrhage Seizures

Keywords

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Subarachnoid Hemorrhage Seizures Prophylaxis Levetiracetam

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Control Group

The control group will not receive levetiracetam as seizure prophylaxis.

Group Type NO_INTERVENTION

No interventions assigned to this group

Treatment Group

levetiracetam 500mg in adults, twice daily, administered by mouth, per tube, or IV. The route of administration will be dependent upon the patient's clinical status and ability to tolerate each form. In descending order of preference, route of administration will be: oral, per tube, IV.

Group Type ACTIVE_COMPARATOR

levetiracetam

Intervention Type DRUG

Interventions

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levetiracetam

Intervention Type DRUG

Other Intervention Names

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keppra

Eligibility Criteria

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Inclusion Criteria

* ≥ 18 years of age
* ≤ 75 years of age
* Newly diagnosed aneurysmal subarachnoid hemorrhage

Exclusion Criteria

* One or more antiepileptic medication is taken as a pre-admission medication
* Seizure occurrence in the field or in the emergency department, or anytime before consent could be obtained
* Inability to obtain informed consent from the patient, or from the patient's appropriate surrogate
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Vanderbilt University Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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J D Mocco, MS, MD

Role: PRINCIPAL_INVESTIGATOR

Vanderbilt University

Michael C Dewan, MD

Role: STUDY_DIRECTOR

Vanderbilt University

Locations

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Vanderbilt University Medical Center

Nashville, Tennessee, United States

Site Status

Countries

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United States

References

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Butzkueven H, Evans AH, Pitman A, Leopold C, Jolley DJ, Kaye AH, Kilpatrick CJ, Davis SM. Onset seizures independently predict poor outcome after subarachnoid hemorrhage. Neurology. 2000 Nov 14;55(9):1315-20. doi: 10.1212/wnl.55.9.1315.

Reference Type BACKGROUND
PMID: 11087774 (View on PubMed)

Choi KS, Chun HJ, Yi HJ, Ko Y, Kim YS, Kim JM. Seizures and Epilepsy following Aneurysmal Subarachnoid Hemorrhage : Incidence and Risk Factors. J Korean Neurosurg Soc. 2009 Aug;46(2):93-8. doi: 10.3340/jkns.2009.46.2.93. Epub 2009 Aug 31.

Reference Type BACKGROUND
PMID: 19763209 (View on PubMed)

Connolly ES Jr, Rabinstein AA, Carhuapoma JR, Derdeyn CP, Dion J, Higashida RT, Hoh BL, Kirkness CJ, Naidech AM, Ogilvy CS, Patel AB, Thompson BG, Vespa P; American Heart Association Stroke Council; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular Nursing; Council on Cardiovascular Surgery and Anesthesia; Council on Clinical Cardiology. Guidelines for the management of aneurysmal subarachnoid hemorrhage: a guideline for healthcare professionals from the American Heart Association/american Stroke Association. Stroke. 2012 Jun;43(6):1711-37. doi: 10.1161/STR.0b013e3182587839. Epub 2012 May 3.

Reference Type BACKGROUND
PMID: 22556195 (View on PubMed)

Hart RG, Byer JA, Slaughter JR, Hewett JE, Easton JD. Occurrence and implications of seizures in subarachnoid hemorrhage due to ruptured intracranial aneurysms. Neurosurgery. 1981 Apr;8(4):417-21. doi: 10.1227/00006123-198104000-00002.

Reference Type BACKGROUND
PMID: 7242892 (View on PubMed)

Hovinga CA. Levetiracetam: a novel antiepileptic drug. Pharmacotherapy. 2001 Nov;21(11):1375-88. doi: 10.1592/phco.21.17.1375.34432.

Reference Type BACKGROUND
PMID: 11714211 (View on PubMed)

Kvam DA, Loftus CM, Copeland B, Quest DO. Seizures during the immediate postoperative period. Neurosurgery. 1983 Jan;12(1):14-7. doi: 10.1227/00006123-198301000-00003.

Reference Type BACKGROUND
PMID: 6828220 (View on PubMed)

Lin CL, Dumont AS, Lieu AS, Yen CP, Hwang SL, Kwan AL, Kassell NF, Howng SL. Characterization of perioperative seizures and epilepsy following aneurysmal subarachnoid hemorrhage. J Neurosurg. 2003 Dec;99(6):978-85. doi: 10.3171/jns.2003.99.6.0978.

Reference Type BACKGROUND
PMID: 14705724 (View on PubMed)

Little AS, Kerrigan JF, McDougall CG, Zabramski JM, Albuquerque FC, Nakaji P, Spetzler RF. Nonconvulsive status epilepticus in patients suffering spontaneous subarachnoid hemorrhage. J Neurosurg. 2007 May;106(5):805-11. doi: 10.3171/jns.2007.106.5.805.

Reference Type BACKGROUND
PMID: 17542523 (View on PubMed)

Mink S, Muroi C, Seule M, Bjeljac M, Keller E. Levetiracetam compared to valproic acid: plasma concentration levels, adverse effects and interactions in aneurysmal subarachnoid hemorrhage. Clin Neurol Neurosurg. 2011 Oct;113(8):644-8. doi: 10.1016/j.clineuro.2011.05.007. Epub 2011 Jun 23.

Reference Type BACKGROUND
PMID: 21703756 (View on PubMed)

Molyneux AJ, Kerr RS, Yu LM, Clarke M, Sneade M, Yarnold JA, Sandercock P; International Subarachnoid Aneurysm Trial (ISAT) Collaborative Group. International subarachnoid aneurysm trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised comparison of effects on survival, dependency, seizures, rebleeding, subgroups, and aneurysm occlusion. Lancet. 2005 Sep 3-9;366(9488):809-17. doi: 10.1016/S0140-6736(05)67214-5.

Reference Type BACKGROUND
PMID: 16139655 (View on PubMed)

Murphy-Human T, Welch E, Zipfel G, Diringer MN, Dhar R. Comparison of short-duration levetiracetam with extended-course phenytoin for seizure prophylaxis after subarachnoid hemorrhage. World Neurosurg. 2011 Feb;75(2):269-74. doi: 10.1016/j.wneu.2010.09.002.

Reference Type BACKGROUND
PMID: 21492729 (View on PubMed)

Beeton AG, Upton PM, Shipton EA. The case for patient-controlled analgesia. Inter-patient variation in postoperative analgesic requirements. S Afr J Surg. 1992 Mar;30(1):5-6.

Reference Type BACKGROUND
PMID: 1566203 (View on PubMed)

Rhoney DH, Tipps LB, Murry KR, Basham MC, Michael DB, Coplin WM. Anticonvulsant prophylaxis and timing of seizures after aneurysmal subarachnoid hemorrhage. Neurology. 2000 Jul 25;55(2):258-65. doi: 10.1212/wnl.55.2.258.

Reference Type BACKGROUND
PMID: 10908901 (View on PubMed)

Rosengart AJ, Huo JD, Tolentino J, Novakovic RL, Frank JI, Goldenberg FD, Macdonald RL. Outcome in patients with subarachnoid hemorrhage treated with antiepileptic drugs. J Neurosurg. 2007 Aug;107(2):253-60. doi: 10.3171/JNS-07/08/0253.

Reference Type BACKGROUND
PMID: 17695377 (View on PubMed)

Shah D, Husain AM. Utility of levetiracetam in patients with subarachnoid hemorrhage. Seizure. 2009 Dec;18(10):676-9. doi: 10.1016/j.seizure.2009.09.003. Epub 2009 Oct 27.

Reference Type BACKGROUND
PMID: 19864168 (View on PubMed)

Sundaram MB, Chow F. Seizures associated with spontaneous subarachnoid hemorrhage. Can J Neurol Sci. 1986 Aug;13(3):229-31. doi: 10.1017/s0317167100036325.

Reference Type BACKGROUND
PMID: 3742338 (View on PubMed)

Szaflarski JP, Sangha KS, Lindsell CJ, Shutter LA. Prospective, randomized, single-blinded comparative trial of intravenous levetiracetam versus phenytoin for seizure prophylaxis. Neurocrit Care. 2010 Apr;12(2):165-72. doi: 10.1007/s12028-009-9304-y.

Reference Type BACKGROUND
PMID: 19898966 (View on PubMed)

Usami K, Saito N. Prophylactic anticonvulsants after subarachnoid hemorrhage. World Neurosurg. 2011 Feb;75(2):214. doi: 10.1016/j.wneu.2010.09.035. No abstract available.

Reference Type BACKGROUND
PMID: 21492717 (View on PubMed)

Other Identifiers

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SPLASH-P1

Identifier Type: -

Identifier Source: org_study_id