A multi-center, open-label, randomized clinical trial evaluating the preventive effect of perampanel on craniotomy-induced epileptogenesis in seizure-naive patients with supratentorial brain tumors: study protocol for a GRAMPAS trial.

IF 2 4区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL
Trials Pub Date : 2024-12-24 DOI:10.1186/s13063-024-08693-7
Junya Yamaguchi, Fumiharu Ohka, Kazuya Motomura, Tomotaka Ishizaki, Norimoto Nakahara, Shigeru Fujitani, Tetsuya Nagatani, Masasuke Ohno, Masahiko Ando, Yachiyo Kuwatsuka, Kazuki Nishida, Ryuta Saito
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引用次数: 0

Abstract

Background: Early seizures after craniotomy are significant perioperative complications that can adversely impact patient outcomes. Despite current guidelines advising against the routine use of antiseizure drugs for seizure after craniotomy prevention due to limited efficacy data, many clinicians continue prescribing them. This discrepancy highlights the need for robust evidence to guide clinical practice. This multi-center, randomized clinical trial was designed to investigate the efficacy of perampanel in preventing early seizures after craniotomy.

Method: This multi-center, open-label, randomized clinical trial will be conducted across five hospitals in Nagoya, Japan, from February 2024 to December 2026. A total of 142 seizure-naive patients with supratentorial brain tumors will be recruited and randomized (1:1) into the treatment and control groups. The treatment group will receive 2 mg of perampanel starting 2 days preoperatively and continuing for 28 days postoperatively, while the control group will receive no antiseizure drugs. The primary outcome is the incidence of seizures within 28 days after craniotomy. Secondary outcomes are length of hospital and intensive care unit stays and postoperative complications.

Discussion: This study addresses the critical need for evidence-based recommendations regarding antiseizure drug use for preventing early seizures after craniotomy. As the first multi-center, randomized trial evaluating perampanel's efficacy in this setting, the findings may significantly influence clinical guidelines and perioperative practices.

Trial registration: This trial was registered with the Japan Registry of Clinical Trials (approval number: jRCTs041230117) on December 18, 2023, a member of the Primary Registry Network of the World Health Organization's International Clinical Trials Registry Platform.

一项多中心、开放标签、随机临床试验评估perampanel对首次发作的幕上脑肿瘤患者开颅诱发的癫痫发生的预防作用:GRAMPAS试验的研究方案。
背景:开颅术后早期癫痫发作是重要的围手术期并发症,可对患者预后产生不利影响。尽管由于有效性数据有限,目前的指南建议不要常规使用抗癫痫药物来预防开颅术后癫痫发作,但许多临床医生仍继续开抗癫痫药物的处方。这种差异强调了需要强有力的证据来指导临床实践。本多中心随机临床试验旨在探讨perampanel预防开颅术后早期癫痫发作的疗效。方法:这项多中心、开放标签、随机临床试验将于2024年2月至2026年12月在日本名古屋的五家医院进行。共招募142例未发作的幕上脑肿瘤患者,按1:1的比例随机分为治疗组和对照组。治疗组术前2天开始给予perampanel 2mg,术后28天继续给予,对照组不给予抗癫痫药物。主要观察指标是开颅后28天内癫痫发作的发生率。次要结局是住院和重症监护病房的时间长短以及术后并发症。讨论:本研究提出了关于使用抗癫痫药物以预防开颅术后早期癫痫发作的循证建议的迫切需要。作为首个在这种情况下评估perampanel疗效的多中心随机试验,研究结果可能会对临床指南和围手术期实践产生重大影响。试验注册:本试验于2023年12月18日在日本临床试验注册中心注册(批准号:jRCTs041230117),该注册中心是世界卫生组织国际临床试验注册平台初级注册网络的成员。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Trials
Trials 医学-医学:研究与实验
CiteScore
3.80
自引率
4.00%
发文量
966
审稿时长
6 months
期刊介绍: Trials is an open access, peer-reviewed, online journal that will encompass all aspects of the performance and findings of randomized controlled trials. Trials will experiment with, and then refine, innovative approaches to improving communication about trials. We are keen to move beyond publishing traditional trial results articles (although these will be included). We believe this represents an exciting opportunity to advance the science and reporting of trials. Prior to 2006, Trials was published as Current Controlled Trials in Cardiovascular Medicine (CCTCVM). All published CCTCVM articles are available via the Trials website and citations to CCTCVM article URLs will continue to be supported.
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