Person:
Simoes Jones, Felipe Jorge

Profile Picture

Email Address

AA Acceptance Date

Birth Date

Research Projects

Organizational Units

Job Title

Last Name

Simoes Jones

First Name

Felipe Jorge

Name

Simoes Jones, Felipe Jorge

Filters

20211

Settings

Author's Publications: search.filters.isAuthorOfPublication.2a334da4-ad17-4783-856d-fe0b9d7a88b7

Search Results

Now showing 1 - 1 of 1
  • No Thumbnail Available
    Publication
    Seizure Prophylaxis After Spontaneous Intracerebral Hemorrhage
    (American Medical Association (AMA), 2021-09-01) Simoes Jones, Felipe Jorge; Sanches, Paula; Smith, Jason; Zafar, Sahar; Blacker, Deborah; Hsu, John; Schwamm, Lee; Newhouse, Joseph; Westover, Michael; Moura, Lidia Maria
    Importance: There is limited evidence concerning optimal seizure prophylaxis after spontaneous intracerebral hemorrhage (sICH). Objective: To evaluate which of four seizure prophylaxis strategies provides the greatest net benefit for sICH patients. Design, Setting, and Participants: Decision model simulating four common scenarios: 1) 60-year-old male with low early- (≤ 7 days post-stroke) (10%) and late-seizure risks (3.6% or 9.8%), and average short- and long-term adverse drug reaction (ADR) risks (9% and 30%, respectively); 2) 80-year-old female with low early- (10%) and late-seizure risks (3.6% or 9.8%), and high short- and long-term ADR risks (24% and 80%); 3) 55-year-old male with high early- (19%) and late-seizure risks (34.8% or 46.2%), and low short- and long-term ADR risks (9% and 30%); and 4) 45-year-old female with high early- (19%) and late-seizure risks (34.8% or 46.2%), and high short- and long-term ADR risks (18% and 60%). Interventions: Four antiseizure drug strategies: 1) Conservative: short-term (7-day) secondary early-seizure prophylaxis with long-term therapy after late-seizure; 2) Moderate: long-term secondary early- or late-seizure prophylaxis; 3) Aggressive: long-term primary prophylaxis; 4) Risk-guided: short-term secondary early-seizure prophylaxis among low-risk patients (2HELPS2B score), short-term primary prophylaxis among higher-risk patients, and long-term late-seizure secondary therapy. Main Outcomes and Measures: Quality-adjusted life years (QALYs). Results: For scenario 1, risk-guided strategy was preferred over conservative, moderate, and aggressive (QALYs = 8.13, 8.08, 8.07, and 7.88, respectively). For scenario 2, conservative and risk-guided strategies performed comparably and were favored over moderate and aggressive (QALYs = 2.18, 2.17, 2.09, 1.15). For scenario 3, aggressive strategy was preferred over moderate, risk-guided and conservative (QALY = 9.21, 8.93, 8.98, 8.77). For scenario 4, risk-guided strategy was preferred over conservative, moderate, and aggressive (QALY = 11.53, 11.23, 10.93, 8.08). Sensitivity analyses suggested that short-term strategies are preferred under most scenarios, and the risk-guided strategy performs comparably or better than alternative strategies in most settings. Conclusions and Relevance: Our model indicates that short-term (7-day) prophylaxis dominates longer-term therapy following sICH. Implementation of the 2HELPS2B score to guide clinical decisions for initiation of short-term primary versus secondary early-seizure prophylaxis should be considered for all patients after sICH.