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14 March 2016

Philadelphia hospitals join study to identify best drug for status epilepticus treatment

Six hospitals in Philadelphia are taking part in a study to find the best possible medical treatment for when a patient is brought in with life-threatening status epilepticus, or a seizure that will not stop on its own or respond to normal medication.

The US study is called Established Status Epilepticus Treatment Trial (ESETT).

Vernon Kalugdan, a clinical research nurse at Temple University Hospital told Philly Voice:"Status epilepticus is a very dangerous disease and if you went to ten different doctors, ten different neurologists, specialists in their field, you might come across ten different opinions for what the best medication is."

The first round of  treatment for status epilepticus in the US is usually Valium.  If this does not work, doctors may move on to any one of three drugs that have been approved by the US Food and Drug Administration (FDA).  The drugs are fosphenytoin, levetiracetam and valproic acid, however, doctors do not know which of them is the most effective. 

In order to find out, over 40 hospitals have agreed to test the drugs in real-life emergency settings.  Any patient over the age of two will be treated as usual, but doctors will choose the second-line medicine at random if Valium is not effective.

The doctors hope that with up to 795 cases to study, they will be able to identify the most successful drug.  This will cut the time it takes for a doctor to choose between the three available drugs, thereby enabling them to treat the patient more quickly.

Patients will not be made aware they are participating in the study until they regain consciousness.  Usually, scientists must obtain permission either from the patient or their guardian to participate in a study.  However, because doctors' response to this life-threatening condition must be as fast as possible, and one of the three medications would have been used anyway, the FDA has waived the informed consent requirement.

Anyone who does not want to participate in the study can request a bracelet that will inform doctors of their decision to opt out.