Prehospital treatment with levetiracetam plus clonazepam or placebo plus clonazepam in status epilepticus (SAMUKeppra): a randomised, double-blind, phase 3 trial

Navarro, Vincent; Dagron, C.; Elie, Caroline; Lamhaut, Lionel; Demeret, Sophie; Urien, Saı̈k; An, Ke; Bolgert, Françis; Tréluyer, Jean‐Marc; Baulac, Michel; Carli, Pierre

doi:10.1016/s1474-4422(15)00296-3

Cited by 119 publications

(144 citation statements)

References 24 publications

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“…In a recent trial, addition of levetiracetam (LEV) to clonazepam had no advantage over clonazepam alone in the control of generalised CSE before admission to hospital. 10 In another randomised, open-label study comparing IV LEV 20 mg/kg over 15 minutes with lorazepam 0.1 mg/kg over 2 to 4 minutes in patients with early SE, both regimens were equally effective. Lorazepam, however, was associated with a significantly higher need for artificial ventilation and insignificantly higher frequency of hypotension.…”

Section: Early Status Epilepticusmentioning

confidence: 97%

Review and update of the Hong Kong Epilepsy Guideline on status epilepticus

Fung

2017

Hong Kong Med J

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Due to the scarcity of publicly available diarization data, the model performance can be improved by training a single model with data from different domains. In this work, we propose to incorporate domain information to train a single end-to-end diarization model for multiple domains. First, we employ domain adaptive training with parameter-efficient adapters for on-the-fly model reconfiguration. Second, we introduce an auxiliary domain classification task to make the diarization model more domain-aware. For seen domains, the combination of our proposed methods reduces the absolute DER from 17.66% to 16.59% when compared with the baseline. During inference, adapters from ground-truth domains are not available for unseen domains. We demonstrate our model exhibits a stronger generalizability to unseen domains when adapters are removed. For two unseen domains, this improves the DER performance from 39.91% to 23.09% and 25.32% to 18.76% over the baseline, respectively.

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Section: Early Status Epilepticusmentioning

confidence: 97%

Review and update of the Hong Kong Epilepsy Guideline on status epilepticus

Fung

2017

Hong Kong Med J

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“…Initial uncontrolled reports suggested a 70% success rate for the treatment of status epilepticus with levetiracetam [23], but a recent randomized controlled trial of out-of-hospital clonazepam plus either levetiracetam or placebo was abandoned because of a lack of benefit in the levetiracetam arm [24]. This mirrors the finding that diazepam plus phenytoin confers no additional benefit to lorazepam alone at 12 h [14] and raises questions around the appropriate timing of the addition of AED to benzodiazepines.…”

Section: Status Epilepticus and Limbic Encephalitismentioning

confidence: 99%

Recent advances in epilepsy

2017

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This paper reviews advances in epilepsy in recent years with an emphasis on therapeutics and underlying mechanisms, including status epilepticus, drug and surgical treatments. Lessons from rarer epilepsies regarding the relationship between epilepsy type, mechanisms and choice of antiepileptic drugs (AED) are explored and data regarding AED use in pregnancy are reviewed. Concepts evolving towards a move from treating seizures to treating epilepsy are discussed, both in terms of the mechanisms of epileptogenesis, and in terms of epilepsy’s broader comorbidity, especially depression.

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“…24 The present study addresses an unmet need in the literature: to evaluate the cost-effectiveness of different nonintravenous rescue medications for pediatric SE in the United States. [27][28][29] Dissolving oral clonazepam wafers and clonazepam liquid are frequently prescribed rescue medications, but data on efficacy are limited to a survey of 16 families of children who used both oral clonazepam and rectal diazepam in the past and reported a roughly similar efficacy.…”

Section: The Role Of Cost-effectiveness In Clinical Decision Makingmentioning

confidence: 99%