Kapur J, Elm J, Chamberlain JM, et al. Randomized trial of three anticonvulsant medications for status epilepticus. N Engl J Med. 2019;381(22):2103-2113.
This randomized blinded trial compared intravenous (IV) levetiracetam, fosphenytoin, and valproate for the management of status epilepticus that is refractory to benzodiazepines. Primary outcomes included the absence of seizures and improved level of consciousness at 60 minutes after beginning treatment. During an interim analysis, it was determined that none of the drugs were inferior or superior, and the trial was stopped based on a rule for futility. The primary outcomes were reached in nearly half of all patients regardless of the medication utilized, and adverse outcomes were similar across the medications.