Biperiden for prevention of post-traumatic epilepsy: A protocol of a double-blinded placebo-controlled randomized clinical trial (BIPERIDEN trial)

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Citações na Scopus
2
Tipo de produção
article
Data de publicação
2022
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ISSN da Revista
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Editora
PUBLIC LIBRARY SCIENCE
Autores
FORESTI, Maira Licia
PINHEIRO, Carla Cristina Gomes
PACHECO, Rafael Leite
RIERA, Rachel
Citação
PLOS ONE, v.17, n.9, article ID e0273584, 11p, 2022
Projetos de Pesquisa
Unidades Organizacionais
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Resumo
Background Traumatic brain injury (TBI) is one of the most important causes of acquired structural epilepsy, post-traumatic epilepsy (PTE), however, efficient preventative measures and treatment are still not available to patients. Preclinical studies indicated biperiden, an anticholinergic drug, as a potential drug to modify the epileptogenic process. The main objective of this clinical trial is to evaluate the efficacy of biperiden as an antiepileptogenic agent in patients that suffered TBI. Methods This prospective multicenter (n = 10) interventional study will include 312 adult patients admitted to emergency care units with a diagnosis of moderate or severe TBI. Following inclusion and exclusion criteria, patients will be randomized, using block randomization, to receive double-blind treatment with placebo or biperiden for 10 days. Follow-up will occur at specific time windows up to 2 years. Main outcomes are incidence of PTE after TBI and occurrence of severe adverse events. Other outcomes include exploratory investigation of factors that might have benefits for the treatment or might influence its results, such as genetic background, clinical progression, electroencephalographic abnormalities, health-related quality of life and neuropsychological status. Analyses will be conducted following the safety, intention-to-treat and efficacy concepts. Discussion We hypothesize that biperiden treatment will be effective to prevent or mitigate the development of post-traumatic epilepsy in TBI patients. Other health measures from this population also may benefit from treatment with biperiden.
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Referências
  1. Annegers JF, 1998, NEW ENGL J MED, V338, P20, DOI 10.1056/NEJM199801013380104
  2. Asikainen I, 1999, EPILEPSIA, V40, P584, DOI 10.1111/j.1528-1157.1999.tb05560.x
  3. Benassi SK, 2021, SEIZURE-EUR J EPILEP, V90, P99, DOI 10.1016/j.seizure.2021.02.031
  4. Bittencourt S, 2017, EPILEPSY RES, V138, P88, DOI 10.1016/j.eplepsyres.2017.10.019
  5. Chan AW, 2013, ANN INTERN MED, V158, P200, DOI 10.7326/0003-4819-158-3-201302050-00583
  6. Cincura C, 2009, CEREBROVASC DIS, V27, P119, DOI 10.1159/000177918
  7. Englander J, 2003, ARCH PHYS MED REHAB, V84, P365, DOI 10.1053/apmr.2003.50022
  8. French JA, 2021, EPILEPSIA OPEN, V6, P483, DOI 10.1002/epi4.12526
  9. Frey LC, 2003, EPILEPSIA, V44, P11, DOI 10.1046/j.1528-1157.44.s10.4.x
  10. Furtado MD, 2012, NEUROTOXICOLOGY, V33, P1476, DOI 10.1016/j.neuro.2012.09.001
  11. Gamble C, 2017, JAMA-J AM MED ASSOC, V318, P2337, DOI 10.1001/jama.2017.18556
  12. Harris PA, 2019, J BIOMED INFORM, V95, DOI 10.1016/j.jbi.2019.103208
  13. Harris PA, 2009, J BIOMED INFORM, V42, P377, DOI 10.1016/j.jbi.2008.08.010
  14. HAUSER WA, 1991, EPILEPSIA, V32, P429, DOI 10.1111/j.1528-1157.1991.tb04675.x
  15. Howick J, 2020, PLOS MED, V17, DOI 10.1371/journal.pmed.1003294
  16. International Conference on Harmonisation of Technical Requirement for Registration of Pharmaceuticals for Human Use, 1994, CLIN SAFETY DATA MAN
  17. LERNER P F, 1960, South Med J, V53, P465
  18. Meller S, 2021, NEUROBIOL DIS, V158, DOI 10.1016/j.nbd.2021.105446
  19. Pitkanen A, 2014, NEUROTHERAPEUTICS, V11, P286, DOI 10.1007/s13311-014-0260-7
  20. Pocock SJ, 1983, CLIN TRIALS PRACTICA, P123
  21. Raymont V, 2010, NEUROLOGY, V75, P224, DOI 10.1212/WNL.0b013e3181e8e6d0
  22. Salazar Andres M, 2015, Handb Clin Neurol, V128, P525, DOI 10.1016/B978-0-444-63521-1.00033-9
  23. Saletti PG, 2019, NEUROBIOL DIS, V123, P86, DOI 10.1016/j.nbd.2018.06.017
  24. Teasdale G, 1979, Acta Neurochir Suppl (Wien), V28, P13
  25. TEMKIN NR, 1990, NEW ENGL J MED, V323, P497, DOI 10.1056/NEJM199008233230801