Resumen
- ANTECEDENTES: Las convulsiones son frecuentes en los cuidados paliativos. Su control es fundamental en el manejo de estos pacientes ya que ayuda a reducir el sufrimiento al final de la vida. El levetiracetam subcutáneo se ha utilizado sin licencia para el control de las convulsiones en cuidados paliativos.OBJETIVO: Describir la experiencia de levetiracetam subcutáneo en dos hospitales de Bogotá, Colombia Métodos: Realizamos una revisión retrospectiva de pacientes tratados con levetiracetam subcutáneo en dos hospitales de Colombia durante 2019-2021. Los datos se extrajeron de las historias clínicas y los participantes fueron seguidos como pacientes ambulatorios.RESULTADOS: Se identificaron veintiún pacientes. No se documentaron efectos adversos graves ni un aumento de la frecuencia ictal. Doce pacientes murieron durante la hospitalización y nueve continuaron el tratamiento como pacientes ambulatorios. El diagnóstico principal fue epilepsia focal estructural. La dosis diaria osciló entre 1000 mg y 3000 mg, y la duración del tratamiento varió entre los sujetos entre 1 y hasta 360 días.
- BACKGROUND: Seizures are common in palliative care. Their control is essential in the management of these patients as it helps to reduce suffering at the end of life. Subcutaneous levetiracetam has been used off-license for seizure control in palliative care.AIM: Describe the experience of subcutaneous levetiracetam in two hospitals in Bogota, Colombia Methods: We conducted a retrospective review of patients treated with subcutaneous levetiracetam in two hospitals in Colombia during 2019-2021.Data were extracted from medical records, and participants were followed up as outpatients.RESULTS: Twenty-one patients were identified. No severe adverse effects or a rise in ictal frequency were documented. Twelve patients died during hospitalization and nine continued treatment as outpatients. The principal diagnosis was structural focal epilepsy. The daily dose ranged from 1000 mg to 3000 mg, and the duration of treatment varied amongst subjects between 1 and up to 360 days.CONCLUSION: In our experience, subcutaneous levetiracetam was well-tolerated and effective in controlling seizures in palliative care when oral administration or intravenous access was not an option. Randomized controlled trials are needed to elucidate the efficacy and tolerability of subcutaneous levetiracetam in clinical practice.