Efficacy and safety of levetiracetam in patients with glioma: a clinical prospective study.

OBJECTIVE To evaluate the efficacy and safety of levetiracetam in the management of epilepsy in patients with glioma. DESIGN A prospective study in hospitalized patients with a new diagnosis of glioma. SETTING Department of Neurological Sciences and Visions, Spedali Civili of Brescia. PATIENTS From March 1, 2006, until January 1, 2009, 176 consecutive patients (101 men and 75 women) with a first diagnosis of glioma were enrolled in the study. All patients with a diagnosis of epilepsy were treated with levetiracetam. MAIN OUTCOME MEASURES Clinical, histological, and magnetic resonance imaging findings were analyzed. RESULTS Age at the diagnosis of glioma ranged from 22 to 79 years (mean [SD], 57 [15] years; median, 59 years). Duration of the disease ranged from 27 days to 2(1/2) years (mean [SD], 13.7 [7.8] months; median, 13 months). Eighty-two patients received levetiracetam because of a diagnosis of epilepsy. At the last evaluation (May 1, 2009), 75 of 82 patients (91%) treated with levetiracetam were seizure free; in 2 of these patients, levetiracetam was withdrawn because of intolerable adverse effects. Prompt and long-lasting control of seizures was obtained in 49 of 82 patients (60%) with a dose of levetiracetam that ranged from 1500 to 3000 mg/d, and 9 (11%) of the treated patients needed an increase of levetiracetam dosage to 4000 mg/d to become seizure free. No laboratory abnormalities were observed in patients with concomitant chemotherapy. CONCLUSION The results of this study provide good evidence that levetiracetam is efficacious and safe in patients with epilepsy due to glioma.