Correlation of enzyme-inducing anticonvulsant use with outcome of patients with glioblastoma.


BACKGROUND:Clinical trials involving patients with glioblastoma (GBM) distinguish cohorts who are treated with enzyme-inducing anticonvulsants (EIAC). Such anticonvulsants induce hepatic P450 microsomal enzymes, which accelerate the metabolism of certain chemotherapy and molecular targeted agents. However, the resultant effect of such induction on patient outcome has received limited study. METHODS:We performed a correlative analysis of baseline EIAC use with outcome, using a cross-sectional database of 620 patients with newly diagnosed GBM treated prospectively on North Central Cancer Treatment Group trials. RESULTS:At registration, 72% were receiving treatment with EIAC; 2% were receiving non-EIACs, and the 26% were not receiving anticonvulsants (26%). Surprisingly, in the multivariable Cox model, overall survival (OS) and progression-free survival (PFS) showed a positive correlation with EIAC use (hazard ratio [HR] = 0.75, p = 0.0028 and HR = 0.80, p = 0.022), even after adjustment for the known prognostic factors of age, performance status, extent of resection, steroid use, and baseline neurocognitive function. Specifically, the median OS was longer in EIAC compared with non-EIAC patients (12.3 vs 10.7 months, p = 0.0002). Similarly, PFS was longer in EIAC patients (5.6 vs 4.8 months, p = 0.003). No differences in median OS or PFS were observed when comparing patients with or without a history of seizures at baseline. CONCLUSIONS:Paradoxically, enzyme-inducing anticonvulsant (EIAC) use correlated with superior outcome of patients with glioblastoma. These results suggest that in comparative clinical trials testing agents metabolized by P450 microsomal enzymes, treatment arms may need stratification for the proportion of patients receiving EIAC.






Jaeckle KA,Ballman K,Furth A,Buckner JC




Has Abstract


2009-10-13 00:00:00














  • Plasmapheresis in acute episodes of fulminant CNS inflammatory demyelination.

    abstract::We present six patients with acute fulminant episodes of CNS inflammatory demyelination who responded to therapeutic plasmapheresis after failing a course of high-dose methylprednisolone administered IV. Neurologic improvement occurred in three of the patients following the second plasmapheresis. Dramatic improvement ...


    pub_type: 杂志文章


    authors: Rodriguez M,Karnes WE,Bartleson JD,Pineda AA

    更新日期:1993-06-01 00:00:00

  • Pharmacologic treatment and evaluation of permanent experimental spinal cord trauma.

    abstract::Permanent paralysis was induced in dogs by a 500 gram centimeter force injury on the spinal cord, and drug treatments were given 1 hour after injury and were continued for 3 days. Dogs were evaluated for 90 days. Isotonic saline or mannitol administration were ineffective in reversing the paralysis. In dogs receiving ...


    pub_type: 杂志文章


    authors: De La Torre JC,Johnson CM,Goode DJ,Mullan S

    更新日期:1975-06-01 00:00:00

  • Genetic dysfunction of MT-ATP6 causes axonal Charcot-Marie-Tooth disease.

    abstract:OBJECTIVE:Charcot-Marie-Tooth (CMT) disease is the most common inherited neuromuscular disorder, affecting 1 in 2,500 individuals. Mitochondrial DNA (mtDNA) mutations are not generally considered within the differential diagnosis of patients with uncomplicated inherited neuropathy, despite the essential requirement of ...


    pub_type: 杂志文章


    authors: Pitceathly RD,Murphy SM,Cottenie E,Chalasani A,Sweeney MG,Woodward C,Mudanohwo EE,Hargreaves I,Heales S,Land J,Holton JL,Houlden H,Blake J,Champion M,Flinter F,Robb SA,Page R,Rose M,Palace J,Crowe C,Longman C,Lu

    更新日期:2012-09-11 00:00:00

  • Long-lasting conduction block in hereditary neuropathy with liability to pressure palsies.

    abstract::We detected 29 conduction blocks in 12 patients with hereditary neuropathy and liability to pressure palsies. The blocks occurred at entrapment sites, most often the ulnar nerve at the elbow. Some had lasted for several years. This kind of block seems to be characteristic of the neuropathy, and may be related to the l...


    pub_type: 杂志文章


    authors: Magistris MR,Roth G

    更新日期:1985-11-01 00:00:00

  • Basal ganglia pathology in ALS is associated with neuropsychological deficits.

    abstract:OBJECTIVES:To evaluate basal ganglia changes along the amyotrophic lateral sclerosis (ALS)-ALS-frontotemporal dementia (FTD) continuum using multiple, complementary imaging techniques. METHODS:Sixty-seven C9orf72-negative patients with ALS and 39 healthy controls were included in a cross-sectional quantitative MRI stu...


    pub_type: 杂志文章


    authors: Machts J,Loewe K,Kaufmann J,Jakubiczka S,Abdulla S,Petri S,Dengler R,Heinze HJ,Vielhaber S,Schoenfeld MA,Bede P

    更新日期:2015-10-13 00:00:00

  • Genetic susceptibility to Parkinson's disease.

    abstract::Genetic factors clearly cause Lewy-body Parkinson's disease (PD) in a subset of autosomal-dominant families. However, most cases of PD are sporadic. The two most likely models of four discussed for sporadic PD are the reduced penetrance model and the multifactorial model. Sporadic PD is likely to be caused by the comb...


    pub_type: 杂志文章,评审


    authors: Johnson WG

    更新日期:1991-05-01 00:00:00

  • Use of statins and incidence of dementia and cognitive impairment without dementia in a cohort study.

    abstract:OBJECTIVE:Evidence of a relation between use of lipid lowering drugs and cognitive outcomes is mixed. This study aimed to test the association between use of statins and incidence of dementia and cognitive impairment without dementia (CIND) over 5 years of follow-up. METHODS:Data were from a population-based cohort st...


    pub_type: 杂志文章


    authors: Cramer C,Haan MN,Galea S,Langa KM,Kalbfleisch JD

    更新日期:2008-07-29 00:00:00

  • Atypical neuronal ceroid-lipofuscinosis.

    abstract::We describe the clinical, pathologic, and ultrastructural findings in a case of juvenile onset neuronal ceroid-lipofuscinosis without visual symptoms or retinal abnormalities. The histochemical and ultrastructural characteristics of the neuronal lipopigment were similar to those in typical cases of neuronal ceroid-lip...


    pub_type: 杂志文章


    authors: Greenwood RS,Nelson JS

    更新日期:1978-07-01 00:00:00

  • Acute hypothalamic stimulation and ongoing cluster headache attacks.

    abstract::Long-term hypothalamic stimulation is effective in improving drug-resistant chronic cluster headache (CH). We assessed acute hypothalamic stimulation to resolve ongoing CH attacks in 16 patients implanted to prevent chronic CH, investigating 136 attacks. A pain intensity reduction of > or =50% occurred in 25 of 108 ev...


    pub_type: 杂志文章


    authors: Leone M,Franzini A,Broggi G,Mea E,Cecchini AP,Bussone G

    更新日期:2006-11-28 00:00:00

  • Evaluation of the safety and immunogenicity of synthetic Abeta42 (AN1792) in patients with AD.

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    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验


    authors: Bayer AJ,Bullock R,Jones RW,Wilkinson D,Paterson KR,Jenkins L,Millais SB,Donoghue S

    更新日期:2005-01-11 00:00:00

  • Sleep, major depressive disorder, and Alzheimer disease: A Mendelian randomization study.

    abstract:OBJECTIVE:To explore the causal relationships between sleep, major depressive disorder (MDD), and Alzheimer disease (AD). METHODS:We conducted bidirectional 2-sample Mendelian randomization analyses. Genetic associations were obtained from the largest genome-wide association studies currently available in UK Biobank (...


    pub_type: 杂志文章


    authors: Huang J,Zuber V,Matthews PM,Elliott P,Tzoulaki J,Dehghan A

    更新日期:2020-10-06 00:00:00

  • Short-term outcomes of skull fracture: a population-based study of survival and neurologic complications.

    abstract::All Olmsted County, Minnesota, residents who experienced brain injury from 1935 through 1979 were identified and their medical records reviewed for survival and neurologic outcome. Minimum inclusion criteria included loss of consciousness or post-traumatic amnesia or neurologic evidence of brain injury or skull fractu...


    pub_type: 杂志文章


    authors: Wiederholt WC,Melton LJ 3rd,Annegers JF,Grabow JD,Laws ER Jr,Ilstrup DM

    更新日期:1989-01-01 00:00:00

  • A pedigree with protanopia and bulbospinal muscular atrophy.

    abstract::We have studied one family of a pedigree in which bulbospinal muscular atrophy and protanopia were segregated. Genotypes for these disorders were obtained on three generations, and the maximum likelihood estimate of recombination fraction was 0.4 with the lod score method. The results indicated that the two loci are n...


    pub_type: 杂志文章


    authors: Mukai E,Yasuma T

    更新日期:1987-06-01 00:00:00

  • Electroencephalographic evaluation in Sturge-Weber syndrome.

    abstract::The most consistent electroencephalographic finding in 16 cases of Sturge-Weber syndrome was a unilateral reduction of background amplitude in the waking record. Comparable asymmetries were noted in those patients in whom sleep recording also was done. Physiologic responses (to hyperventilation and photic driving) usu...


    pub_type: 杂志文章


    authors: Brenner RP,Sharbrough FW

    更新日期:1976-07-01 00:00:00

  • Evaluation of hyperacute infarct volume using ASPECTS and brain CT perfusion core volume.

    abstract:OBJECTIVE:To compare the accuracy of Alberta Stroke Program Early Computed Tomography Score (ASPECTS) and CT perfusion to detect established infarction in acute anterior circulation stroke. METHODS:We performed an observational study in 59 acute anterior circulation ischemic stroke patients who underwent brain noncont...


    pub_type: 杂志文章


    authors: Demeestere J,Garcia-Esperon C,Garcia-Bermejo P,Ombelet F,McElduff P,Bivard A,Parsons M,Levi C

    更新日期:2017-06-13 00:00:00

  • A novel sodium channel mutation in a family with hypokalemic periodic paralysis.

    abstract:OBJECTIVE:To identify the cause of hypokalemic periodic paralysis (HOKPP) in a family whose disease is not caused by a mutation in the dihydropyridine-sensitive (DHP) receptor alpha1-subunit gene (CACNA1S). BACKGROUND:Hypokalemic periodic paralysis is primarily caused by mutations within CACNA1S. Genetic heterogeneity...


    pub_type: 杂志文章


    authors: Bulman DE,Scoggan KA,van Oene MD,Nicolle MW,Hahn AF,Tollar LL,Ebers GC

    更新日期:1999-12-10 00:00:00

  • Upholding professionalism: the disciplinary process of the American Academy of Neurology.

    abstract:OBJECTIVE:To review the disciplinary process by which the American Academy of Neurology (AAN) enforces its formalized standards of professional conduct. METHODS:We reviewed the AAN's Disciplinary Action Policy. We tracked the elapsed time from receipt to final decision of all allegations ("complaints") of improper con...


    pub_type: 杂志文章


    authors: Hutchins JC,Sagsveen MG,Larriviere D

    更新日期:2010-12-14 00:00:00

  • Plasmapheresis in multiple sclerosis: preliminary findings.

    abstract::In seven of eight patients with progressive multiple sclerosis subjected to long-term plasmapheresis in combination with azathioprine and pulsed prednisone therapy, we found modest improvement of neurologic function. There was no change in auditory and visual evoked responses or serum demyelinating activity. In six of...


    pub_type: 杂志文章


    authors: Dau PC,Petajan JH,Johnson KP,Panitch HS,Bornstein MB

    更新日期:1980-10-01 00:00:00

  • Surgical treatment of carpal tunnel syndrome in patients with peripheral neuropathy.

    abstract::Outcome after carpal tunnel surgery was studied retrospectively in 32 patients with peripheral neuropathy and carpal tunnel syndrome. Nocturnal paresthesias were almost universally relieved, followed in order of responsiveness by pain, numbness, and weakness. Twenty-five of 28 patients said they would have the surgery...


    pub_type: 杂志文章


    authors: Morgenlander JC,Lynch JR,Sanders DB

    更新日期:1997-10-01 00:00:00

  • Serotonin syndrome induced by transitioning from phenelzine to venlafaxine: four patient reports.

    abstract::With the use of the newer antidepressants beyond the traditional tricyclics and monoamine oxidase inhibitors, newer options in headache prophylaxis are provided as well as the potential for undesirable and even potentially life-threatening interactions between medications. In this article, four patient reports of a sp...


    pub_type: 杂志文章


    authors: Diamond S,Pepper BJ,Diamond ML,Freitag FG,Urban GJ,Erdemoglu AK

    更新日期:1998-07-01 00:00:00

  • Exercise-induced membrane failure in paramyotonia congenita.

    abstract::A marked decrease in the amplitude of the evoked thenar compound muscle action potential followed brief exercise at room temperature in two patients with paramyotonia congenita. This decline was more rapid and pronounced in our patient with coexistent thyrotoxicosis. The prolonged recovery period in paramyotonia conge...


    pub_type: 杂志文章


    authors: Gutmann L,Riggs JE,Brick JF

    更新日期:1986-01-01 00:00:00

  • Stem cell therapy in ischemic stroke: role of IV and intra-arterial therapy.

    abstract:OBJECTIVE:Cell-based therapies are being investigated as an adjunct to IV thrombolysis or mechanical thrombectomy in ischemic stroke. This review summarizes the potential applications as well as challenges of intravascular cell delivery in ischemic stroke. METHOD:We conducted a search of Medline as well as the clinica...


    pub_type: 杂志文章,评审


    authors: Misra V,Ritchie MM,Stone LL,Low WC,Janardhan V

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  • Dementia in hippocampal sclerosis resembles frontotemporal dementia more than Alzheimer disease.

    abstract:OBJECTIVE:To characterize the clinical course of pathologically diagnosed hippocampal sclerosis dementia (HSD). BACKGROUND:Dementia associated with HSD is incompletely characterized. Previous studies suggest similarities to both Alzheimer disease (AD) and frontotemporal dementia (FTD). METHODS:Case-control analysis o...


    pub_type: 杂志文章


    authors: Blass DM,Hatanpaa KJ,Brandt J,Rao V,Steinberg M,Troncoso JC,Rabins PV

    更新日期:2004-08-10 00:00:00

  • Zoonotic bacterial meningitis in human adults.

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    pub_type: 杂志文章,评审


    authors: van Samkar A,Brouwer MC,van der Ende A,van de Beek D

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    pub_type: 杂志文章


    authors: Pasi M,Boulouis G,Fotiadis P,Auriel E,Charidimou A,Haley K,Ayres A,Schwab KM,Goldstein JN,Rosand J,Viswanathan A,Pantoni L,Greenberg SM,Gurol ME

    更新日期:2017-06-06 00:00:00

  • Botulinum toxin for blepharospasm: single-fiber EMG studies.

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    pub_type: 杂志文章


    authors: Sanders DB,Massey EW,Buckley EG

    更新日期:1986-04-01 00:00:00

  • Identification, causation, alleviation, and prevention of complications (ICAP): an approach to symptom and disability management in multiple sclerosis.

    abstract::Comprehensive management of patients with multiple sclerosis (MS) includes treatment to modify the disease course and interventions to address the persistent symptoms and consequences of this chronic illness, which can affect patients for decades. Although much excitement and attention accompanies new therapeutic init...


    pub_type: 杂志文章


    authors: Cohen BA

    更新日期:2008-12-09 00:00:00

  • Association of aortic plaque with intracranial atherosclerosis in patients with stroke.

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    pub_type: 杂志文章


    authors: Nam HS,Han SW,Lee JY,Ahn SH,Ha JW,Rim SJ,Lee BI,Heo JH

    更新日期:2006-10-10 00:00:00

  • Norms for the Mini-Mental State Examination in a healthy population.

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    pub_type: 杂志文章


    authors: Grigoletto F,Zappalà G,Anderson DW,Lebowitz BD

    更新日期:1999-07-22 00:00:00

  • Optic nerve edema as a consequence of respiratory disease.

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    pub_type: 杂志文章


    authors: O'Halloran HS,Berger JR,Baker RS,Lee WB,Pearson PA,Ryan S

    更新日期:1999-12-10 00:00:00