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LEVETIRACETAM IS INDEPENDENTLY ASSOCIATED WITH FATIGUE IN ADULT GLIOMA OUTPATIENTS
  1. Karolis Zienius1,
  2. Alasdair Rooney2,
  3. Robert Grant3
  1. 1Victoria Hospital Kirkcaldy, Fife
  2. 2University of Edinburgh
  3. 3Edinburgh Centre for Neuro-Oncology, Western General Hospital, Edinburgh

Abstract

Aims To identify the frequency and severity of fatigue in adults with cerebral glioma, and its association with anti-epileptic drugs (AED).

Methods Cross-sectional study. Stable glioma patients attending Edinburgh Neuro-Oncology clinic completed a fatigue Visual Analogue Scale (range 0-100mm, “high” >=60 mm). AED type and dose were recorded.

Results One hundred and sixty six patients were enrolled (61% males; mean age 49 yrs; 70% high-grade glioma). Among all patients, 43% reported high fatigue (95% CI 35–50%). Sixty eight percent were taking AEDs (58% of which were non enzyme inducing). Levetiracetam (LEV) was the most common AED. LEV monotherapy correlated with higher fatigue levels (mean=57 mm, SD 5.2, 95% CI 46–67 mm), compared with other AEDs (mean=43 mm, SD 3.9, 95% CI 35–50 mm, ANCOVA p=0.04). Patients taking LEV had poorer Karnofsky Performance Scores (KPS, Mann–Whitney p=0.03). The effect of LEV on fatigue was independent of KPS (LR p<0.0001, R2= 27.7, OR 2.7 [1.1–6.2]).

Conclusions Glioma patients on levetiracetam therapy are more fatigued than patients on other or no anti-epileptic therapy. Changes to AED medications may benefit patients with troublesome fatigue.

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