P450 enzyme-inducing and non-enzyme-inducing antiepileptic drugs for seizure prophylaxis after glioma resection surgery: a meta-analysis

Abstract

Purpose: The prognoses of seizure treatment with P450 enzyme-inducing and non-enzyme-inducing antiepileptic drugs after glioma resection surgery were investigated across several clinical studies. However, the results of these studies are inconsistent. We examined the relevant studies and conducted a meta-analysis of these two types of anti-epileptic drugs.

Methods: A bibliography search using the EMBASE, MEDLINE, ClinicalTrials.gov, and Cochrane Central Register of Controlled Trials databases was performed to identify potentially relevant articles and conference abstracts that investigated the effects of non-enzyme-inducing antiepileptic drugs (NEIAEDs) and enzyme-inducing antiepileptic drugs (EIAEDs) on the seizure prognoses of glioma patients.

Results: One RCT study and five observational studies were included. Pooled estimates of the relative risks (OR) and 95% confidence intervals (CI) were calculated. The pooled odds ratio for NEIAEDs vs. EIAEDs for patients with glioma was 1.12 (95% CI=0.70-2.10). The pooled odds ratio for NEIAEDs vs. EIAEDs for low-grade gliomas was 1.77 (95% CI=0.71-4.40). The pooled odds ratio for LEV vs. PHY was 1.459 (95% CI=0.731-2.910).

Conclusions: No significant difference between the efficacies of P450 enzyme-inducing and non-enzyme-inducing antiepileptic drugs for prophylactic late seizure treatment was observed. However, few RCTs were available, and the acquisition of further evidence through high-quality RCTs is highly recommended.

Keywords: AEDs; Glioma; P450; Treatment.