Document Detail


Temozolomide treatment does not affect topiramate and oxcarbazepine plasma concentrations in chronically treated patients with brain tumor-related epilepsy.
MedLine Citation:
PMID:  18612799     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Medical management of brain tumor-related epilepsy is complicated by interactions between antiepileptic and chemotherapeutic drugs. We studied the effect of temozolomide therapy on the disposition of the new antiepileptic drugs topiramate (TPM) or oxcarbazepine (OXC).
METHODS: Fifteen patients chronically treated with TPM or OXC in monotherapy starting a chemotherapeutic treatment with temozolomide were enrolled in the study, of which ten were available for the final analyses. Blood samples were collected before temozolomide treatment (T(0)), at its end (T(7)) and after further 1-3 weeks (T(14)-T(28)). For each patient, more than one treatment cycle was studied. Topiramate and OXC mono-10-hydroxy derivative (MHD) plasma concentrations were determined by hplc coupled with ion spray mass spectrometer (TPM) or ultraviolet (MHD) detection.
RESULTS: Mean TPM concentrations were 5.4 +/- 2.4 microg/ml at T(0) vs. 5.5 +/- 2.4 microg/ml at T(7) (n = 14), and 5.4 +/- 2.4 microg/ml at T(0) vs. 5.6 +/- 2.8 microg/ml at T(14)-T(28) (n = 14). Mean MHD concentrations were 16.4 +/- 7.6 microg at T(0) vs. 18.5 +/- 9.0 microg/ml at T(7) (n = 5), and 16.8 +/- 7.0 microg/ml at T(0) vs. 18.0 +/- 8.7 microg/ml at T(14)-T(28) (n = 8) (all comparisons not statistically significant; Student's t-test for paired samples).
CONCLUSION: Temozolomide treatment did not affect TPM plasma concentrations in chronically treated patients. Data for MHD in OXC-treated patients were similar, but, due to the small sample size, results should be interpreted cautiously.These findings confirm that TPM (and possibly OXC) are a reasonable choice of antiepileptic drug in patients with brain tumor-related epilepsy.
Authors:
Marta Maschio; Fiorenzo Albani; Bruno Jandolo; Alessia Zarabla; Manuela Contin; Loredana Dinapoli; Alessandra Fabi; Andrea Pace; Agostino Baruzzi
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2008-07-09
Journal Detail:
Title:  Journal of neuro-oncology     Volume:  90     ISSN:  0167-594X     ISO Abbreviation:  J. Neurooncol.     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-10-02     Completed Date:  2009-01-13     Revised Date:  2013-08-21    
Medline Journal Info:
Nlm Unique ID:  8309335     Medline TA:  J Neurooncol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  217-21     Citation Subset:  IM    
Affiliation:
Center for tumor-related epilepsy, Department of Neuroscience and Cervical-Facial Pathology, National Institute for Cancer "Regina Elena", Via Elio Chianesi 53, 00144 Rome, Italy. maschio@ifo.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Anticonvulsants / blood,  therapeutic use*
Antineoplastic Agents, Alkylating / therapeutic use*
Brain Neoplasms / complications*,  drug therapy*
Carbamazepine / analogs & derivatives*,  blood,  therapeutic use
Dacarbazine / analogs & derivatives*,  therapeutic use
Epilepsy / blood,  drug therapy*,  etiology*
Female
Follow-Up Studies
Fructose / analogs & derivatives*,  blood,  therapeutic use
Humans
Male
Middle Aged
Young Adult
Chemical
Reg. No./Substance:
0/Anticonvulsants; 0/Antineoplastic Agents, Alkylating; 0H73WJJ391/topiramate; 298-46-4/Carbamazepine; 30237-26-4/Fructose; 4342-03-4/Dacarbazine; 85622-93-1/temozolomide; VZI5B1W380/oxcarbazepine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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