Please summarize the current level of evidence to use weight based levetiracetam dosing vs standard dosing for seizure prophylaxis in neurocritically ill patients

Comment by InpharmD Researcher

Based on a 2024 pharmacokinetic analysis, weight-based levetiracetam dosing (40-60 mg/kg) is superior to fixed dosing for maintaining therapeutic drug levels for 12 hours, especially in patients with higher body weights. This suggests a weight-based strategy could be more reliable for sustained seizure prophylaxis. However, additional data specifically comparing the two dosing strategies is lacking.

Background

A 2024 meta-regression and pharmacokinetic modeling analysis evaluated the effectiveness of fixed and weight-based loading doses of levetiracetam (LEV) in achieving therapeutic plasma concentrations in patients with refractory status epilepticus. The study employed a meta-regression approach to assess the relationship between intravenous LEV loading doses and seizure cessation, examining data from five clinical studies involving 297 patients. These studies explored intravenous LEV doses ranging from 20 to 60 mg/kg, infused over durations of 30 minutes or less. The analysis found no significant linear relationship between the LEV dosage and the likelihood of seizure cessation, suggesting that all dosing regimens were equally effective in achieving seizure control. The research also utilized a previously established population pharmacokinetic model to simulate and compare the efficacy of different dosing strategies in achieving maximum and 12-hour post-dose plasma concentrations above 12 mg/L. These simulations revealed that while all dosing schemes exceeded the minimum effective concentration shortly after administration, only weight-based doses of 40 and 60 mg/kg consistently maintained therapeutic levels across various body weights up to 12 hours post-dose. In contrast, fixed dosing schemes showed a reduced probability of maintaining therapeutic concentrations, particularly in heavier individuals. These findings underscore the advantage of a weight-based loading dose strategy for LEV to ensure sustained therapeutic drug levels in patients with benzodiazepine-refractory status epilepticus. [1]

A 2008 review focused on the oral loading dose of levetiracetam mentioned in its body hat weight-based dosing of levetiracetam may be considered in patients with ideal body weight or at extremes of ideal body weight. However, no further context was given for this statement. [2]

References:

[1] Lau A, Haag H, Maharaj A. A Simulation-Based Assessment of Levetiracetam Concentrations Following Fixed and Weight-Based Loading Doses: A Meta-Regression and Pharmacokinetic Modeling Analysis. J Clin Pharmacol. 2024;64(9):1173-1180. doi:10.1002/jcph.2449
[2] Koubeissi MZ, Amina S, Pita I, Bergey GK, Werz MA. Tolerability and efficacy of oral loading of levetiracetam. Neurology. 2008;70(22 Pt 2):2166-2170. doi:10.1212/01.wnl.0000313151.64005.c0

Literature Review

A search of the published medical literature revealed 1 study investigating the researchable question:

Please summarize the current level of evidence to use weight based levetiracetam dosing vs standard dosing for seizure prophylaxis in neurocritically ill patients

Level of evidence

C - Multiple studies with limitations or conflicting results  Read more→



Please see Table 1 for your response.


Optimal Dosing of Levetiracetam for Seizure Prophylaxis in Critically Ill Patients: A Prospective Observational Study
Design Prospective, observational study N= 205
Objective To compare the rates of achievement of target serum levels and new onset seizure (clinical and/or electrographic) among patients who received low (500 mg bid) versus high (750–1,000 mg bid) dose LEV
Study Groups Low-dose LEV (n= 106) High-dose LEV (n= 99)
Inclusion Criteria Patients who received prophylactic LEV following traumatic brain injury, intracerebral hemorrhage, spontaneous subarachnoid hemorrhage, or supratentorial neurosurgery between 2019 and 2021
Exclusion Criteria Patients with a history of seizure, antiseizure medication use, or renal failure requiring dialysis
Methods

LEV levels were obtained at steady state. The impact of low-dose versus high-dose LEV on the primary outcome of target LEV levels (12–46 μg/mL), and the secondary outcome of clinical and/or electrographic seizure, were assessed using multivariable logistic regression analyses adjusting for age, LEV loading dose, BMI, primary diagnosis and creatinine clearance (CrCl).

The weight-based maintenance dose underwent a sensitivity analysis as a continuous variable in lieu of low-dose versus high-dose dichotomization.

Duration July 2019 to August 2021
Outcome Measures

Primary: Target serum LEV levels (12–46 μg/mL)

Secondary: Multivariable Logistic Regression Results for the Outcome of Target Serum Level for the weight-based maintenance dose.

Baseline Characteristics Measure 500 mg bid (n = 106) 750 or 1,000 mg bid (n = 99)    
Age (median, IQR) 66 (50–78) 62 (49–70)    
Weight (kg) (median, IQR) 75 (65–83.9) 73.3 (63–85.2)    
Height (cm) (median, IQR) 168 (158–175) 168 (163–173)    
BMI (kg/m2) (median, IQR) 25.8 (23.7–29.1) 26.3 (22.4–30.1)    
Sex (female), n (%) 46/106 (43%) 43/99 (43%)    
Race, n (%) - White 50/106 (47.2%) 40/99 (39.4%)    
Race, n (%) - Black 12/106 (11.3%) 14/99 (14.1%)    
Race, n (%) - Asian 19/106 (17.9%) 17/99 (18.2%)    
Race, n (%) - Other 25/106 (23.6%) 28/99 (28.3%)    
Highest level of care, n (%) - Intensive care 98/106 (93%) 97/99 (98%)    
Principal diagnosis, n (%) - Traumatic brain injury 54/106 (50.9%) 43/99 (43.4%)    
Principal diagnosis, n (%) - Spontaneous subarachnoid hemorrhage 24/106 (22.6%) 23/99 (23.2%)    
Principal diagnosis, n (%) - Supratentorial surgery 20/106 (18.9%) 23/99 (23.2%)    
Principal diagnosis, n (%) - ICH 8/106 (7.5%) 10/99 (10.1%)    
Admission laboratories (median, IQR) - Creatinine (mg/dL) 0.85 (0.73–1.07) 0.92 (0.74–1.24)    
Admission laboratories (median, IQR) - Creatinine clearance (mL/min) 79.4 (59.5–110.1) 83.9 (61.0–107.4)    
Creatinine clearance < 30 mL/min, n (%) 3/106 (2.8%) 0    
Augmented creatinine clearance ≥ 130 mL/min, n (%) 16/106 (15%) 14/99 (14%)    
EEG monitoring, n (%) 41/106 (39%) 36/99 (36%)    
Days from admission to EEG monitoring (median, IQR) 4 (1–9) 2 (2–4)    
Hours on EEG (median, IQR) 48 (30–48) 48 (48–48)    
Length of stay (median, IQR) 8 (5–18) 10 (5–21)    
Levetiracetam dosage - Loading dose (mg), median (IQR) 1,000 (500–1,000) 1,000 (1,000–1,000)    
Levetiracetam dosage - Loading dose route IV (vs PO), n (%) 93/106 (88%) 91/99 (92%)    
Levetiracetam dosage - Maintenance dose (mg/kg/d) (median, IQR) 13 (12–15) 25 (19–30)    
Levetiracetam dosage - Maintenance dose ≥ 20 mg/kg/d, n (%) 9/106 (8.5%) 73/99 (73.7%)    
Levetiracetam dosage - Duration of treatment (d) (median, IQR) 7 (4–10) 6 (4–9)    
Results Outcome Low-Dose LEV 500 mg bid (n = 106) High-Dose LEV 750 or 1,000 mg bid (n = 99) p-Value  
Therapeutic serum level (12–46 μg/mL) 48/106 (45.3%) 63/99 (63.6%) 0.008  
  Seizure (n= 26) No seizure (n= 179)   Odds ratio
Maintenance dose (mg/kg/d), median 18.4 (13.1–25.0) 15.2 (12.9–23.8) 0.029 0.93 (0.87–0.99)
Adverse Events Not specifically reported in the study
Study Author Conclusions

Underdosing of LEV was common, with only 54% of patients achieving target serum levels. Higher doses (750–1,000 mg bid) were more than twice as likely to lead to optimal drug levels and reduced the odds of seizure by 68% compared with low-dose regimens (500 mg bid).

Critique

The study provides valuable insights into the dosing of LEV for seizure prophylaxis in critically ill patients, highlighting the need for higher doses to achieve therapeutic levels. However, the observational design limits the ability to control for all confounding variables, and the lack of continuous EEG monitoring for all patients may have led to an underestimation of seizure rates. Additionally, the study did not systematically track adverse events, which could provide a more comprehensive understanding of the safety profile of higher LEV doses.

 

References:

Valdes E, Fang T, Boffa M, Frontera JA. Optimal Dosing of Levetiracetam for Seizure Prophylaxis in Critically Ill Patients: A Prospective Observational Study. Crit Care Med. 2024;52(1):e1-e10. doi:10.1097/CCM.0000000000006065