Impact of meningioma surgery on use of antiepileptic, antidepressant, and sedative drugs: A Swedish nationwide matched cohort study.
Aged
Anticonvulsants
/ therapeutic use
Antidepressive Agents
/ therapeutic use
Anxiety
/ drug therapy
Case-Control Studies
Cohort Studies
Depression
/ drug therapy
Epilepsy
/ drug therapy
Female
Humans
Hypnotics and Sedatives
/ therapeutic use
Logistic Models
Male
Meningeal Neoplasms
/ epidemiology
Meningioma
/ epidemiology
Middle Aged
Postoperative Care
/ statistics & numerical data
Preoperative Care
/ statistics & numerical data
Registries
/ statistics & numerical data
Sweden
/ epidemiology
Time Factors
anti-epileptic drugs
antidepressant
neurosurgery
primary brain tumor
quality of life
Journal
Cancer medicine
ISSN: 2045-7634
Titre abrégé: Cancer Med
Pays: United States
ID NLM: 101595310
Informations de publication
Date de publication:
05 2021
05 2021
Historique:
revised:
30
12
2020
received:
02
09
2020
accepted:
12
03
2021
pubmed:
28
3
2021
medline:
21
7
2021
entrez:
27
3
2021
Statut:
ppublish
Résumé
Meningioma is the most common primary intracranial tumor and surgery is the main treatment modality. As death from lack of tumor control is rare, other outcome measures like anxiety, depression and post-operative epilepsy are becoming increasingly relevant. In this nationwide registry-based study we aimed to describe the use of antiepileptic drugs (AED), antidepressants and sedatives before and after surgical treatment of an intracranial meningioma compared to a control population, and to provide predictors for continued use of each drug-group two years after surgery. All adult patients with histopathologically verified intracranial meningiomas were identified in the Swedish Brain Tumor Registry and their data were linked to relevant national registries after assigning five matched controls to each patient. We analyzed the prescription patterns of antiepileptic drugs (AED), antidepressants and sedative drugs in the two years before and the two years following surgery. For the 2070 patients and 10312 controls identified the use of AED, antidepressants and sedatives was comparable two years before surgery. AED use at time of surgery was higher for patients than for controls (22.2% vs. 1.9%, p < 0.01), as was antidepressant use (12.9% vs. 9.4%, p < 0.01). Both AED and antidepressant use remained elevated after surgery, with patients having a higher AED use (19.7% vs. 2.3%, p < 0.01) and antidepressant use (14.8% vs. 10.6%, p < 0.01) at 2 years post-surgery. Use of sedatives peaked for patients at the time of surgery (14.4% vs. 6.1%, p < 0.01) and remained elevated at two years after surgery with 9.9% versus 6.6% (p < 0.01). For all the studied drugs, previous drug use was the strongest predictor for use 2 years after surgery. This nationwide study shows that increased use of AED, antidepressants and sedatives in patients with meningioma started perioperatively, and remained elevated two years following surgery.
Sections du résumé
BACKGROUND
Meningioma is the most common primary intracranial tumor and surgery is the main treatment modality. As death from lack of tumor control is rare, other outcome measures like anxiety, depression and post-operative epilepsy are becoming increasingly relevant. In this nationwide registry-based study we aimed to describe the use of antiepileptic drugs (AED), antidepressants and sedatives before and after surgical treatment of an intracranial meningioma compared to a control population, and to provide predictors for continued use of each drug-group two years after surgery.
METHODS
All adult patients with histopathologically verified intracranial meningiomas were identified in the Swedish Brain Tumor Registry and their data were linked to relevant national registries after assigning five matched controls to each patient. We analyzed the prescription patterns of antiepileptic drugs (AED), antidepressants and sedative drugs in the two years before and the two years following surgery.
RESULTS
For the 2070 patients and 10312 controls identified the use of AED, antidepressants and sedatives was comparable two years before surgery. AED use at time of surgery was higher for patients than for controls (22.2% vs. 1.9%, p < 0.01), as was antidepressant use (12.9% vs. 9.4%, p < 0.01). Both AED and antidepressant use remained elevated after surgery, with patients having a higher AED use (19.7% vs. 2.3%, p < 0.01) and antidepressant use (14.8% vs. 10.6%, p < 0.01) at 2 years post-surgery. Use of sedatives peaked for patients at the time of surgery (14.4% vs. 6.1%, p < 0.01) and remained elevated at two years after surgery with 9.9% versus 6.6% (p < 0.01). For all the studied drugs, previous drug use was the strongest predictor for use 2 years after surgery.
CONCLUSION
This nationwide study shows that increased use of AED, antidepressants and sedatives in patients with meningioma started perioperatively, and remained elevated two years following surgery.
Identifiants
pubmed: 33773085
doi: 10.1002/cam4.3868
pmc: PMC8085957
doi:
Substances chimiques
Anticonvulsants
0
Antidepressive Agents
0
Hypnotics and Sedatives
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2967-2977Informations de copyright
© 2021 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
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