Table 4.
Summary of clinical outcomes reported by the four included trials
| Study ID | Arm | Seizure cessation | Recurrence of seizures | |||
|---|---|---|---|---|---|---|
| Number of people with cessation of seizure activity, n (%) | Effect estimate | Time to seizure cessation from admin of study drug, minutes | Number of people with recurrence of seizures, n (%) | Time from seizure cessation to recurrence, minutes, mean (SD) | ||
| [15] | IV lorazepam (n = 66) | 39/66 (59.1%) |
OR (95% CI)a Lorazepam vs placebo: 4.8 (1.9, 13.0) Lorazepam vs diazepam: 1.9 (0.8, 4.4) Diazepam vs placebo: 2.3 (1.0–5.9) |
HR (95% CI)b Lorazepam vs placebo: 2.94 (1.41, 5.88) Lorazepam vs diazepam: 1.54 (0.85, 2.77) |
NR | NR |
| IV diazepam (n = 68) | 29/68 (42.6%) | NR | NR | |||
| IV placebo (n = 71) | 15/71 (21.1%) | NR | NR | |||
| [21] | IV levetiracetam + clonazepam (n = 68) | 50/68 (73.5%) |
RR (95% CI) 0·88 (0·74–1·05) |
Median 3 (range 0–50) | 7/67 (10.4%)c | NR |
| IV placebo + clonazepam (n = 68) | 57/68 (83.8%) | Median 5 (range 0–41) | 13/68 (19.1%)c | NR | ||
| [23] | IV phenobarbital + phenytoin (n = 18) | 13/18 (72.2%) | NR | Median 5.5 | NR | NR |
| IV diazepam + phenytoin (n = 18) | 6/18 (33.3%) | Median 15 | NR | NR | ||
| [22] | IM midazolam (n = 391) | 289/391 (73.9%) | NR | Median 3 (IQR 2, 6.3) | 47/391 (12.0%)d | NR |
| IV lorazepam (n = 391) | 244/391 (62.4%) | Median 2 (IQR 1, 4.4) | 42/391 (10.7%)d | NR | ||
AD absolute difference; HR hazard ratio; IM intramuscular; IV intravenous; NR not reported; OR odds ratio; RR relative risk; SD standard deviation
aAdjusted for race or ethnic group, the intervals from the onset of status epilepticus to study treatment and from study treatment to arrival at the emergency department, and cause of status epilepticus within each prognostic group
bAdjusted for covariates (no further details provided)
cp = 0.16
dWithin 12 h of ED arrival