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Journal of Neuro-Oncology

, Volume 129, Issue 3, pp 461–469 | Cite as

Does the choice of antiepileptic drug affect survival in glioblastoma patients?

  • Kristin M. Knudsen-BaasEmail author
  • Anders Engeland
  • Nils Erik Gilhus
  • Anette M. Storstein
  • Jone F. Owe
Clinical Study

Abstract

Patients with glioblastoma (GBM) often suffer from symptomatic epilepsy. Older antiepileptic drugs (AEDs) which affect the enzyme system cytochrome P450 have been in extensive use, but there is an increasing focus on interactions with other drugs. This study investigated whether newer AEDs with little or no enzyme effect are increasingly preferred. Previous research has indicated that valproate improves survival in GBM. We investigated the impact of AEDs on overall survival in GBM patients. All GBM patients diagnosed in Norway 2004–2010 were included through a linkage of national registries, and follow-up data on the malignancy and drug usage were analyzed. In a multivariate cox proportional-hazards regression, AEDs were adjusted for each other and for relevant factors. Immortal time bias was eliminated with time-dependent variables. The study population was 1263 patients with histologically confirmed GBM. Carbamazepine was the most frequently prescribed AED to patients diagnosed with GBM during 2004–2006, while levetiracetam was increasingly prescribed to patients diagnosed later. Taking AEDs on a reimbursement code of epilepsy was not beneficial for survival. None of the six AEDs valproate, levetiracetam, carbamazepine, oxcarbazepine, lamotrigine or phenytoin significantly altered overall survival. There has been a shift in the prescriptions of AEDs to GBM patients from older to newer AEDs over time. We found no significant survival benefit in GBM patients neither from treatment with AEDs for epilepsy in general, nor from the usage of six separate AEDs.

Keywords

Antiepileptic drugs Epilepsy Glioblastoma National registries Overall survival 

Notes

Acknowledgments

The study has used data from the Cancer Registry of Norway. The interpretation and reporting of these data are the sole responsibility of the authors, and no endorsement by the Cancer Registry of Norway is intended nor should be inferred. We thank Tom Børge Johannesen (MD, PhD) for facilitating the data collection in this study.

Funding

Department of Clinical Medicine 1, University of Bergen, Norway.

Compliance with ethical standards

The study employs anonymous data in mandatory national registries only and complies with the ethical standards for use of these registries.

Conflict of interest

The authors declare no conflict of interest.

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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Kristin M. Knudsen-Baas
    • 1
    • 2
    Email author
  • Anders Engeland
    • 3
    • 4
  • Nils Erik Gilhus
    • 1
    • 2
  • Anette M. Storstein
    • 1
    • 2
  • Jone F. Owe
    • 1
  1. 1.Department of NeurologyHaukeland University HospitalBergenNorway
  2. 2.Department of Clinical Medicine 1University of BergenBergenNorway
  3. 3.Department of Pharmacoepidemiology, Domain of Mental and Physical HealthNorwegian Institute of Public HealthBergenNorway
  4. 4.Department of Global Public Health and Primary CareUniversity of BergenBergenNorway

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