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The effectiveness of antiepileptic drug treatment in glioma patients: lamotrigine versus lacosamide
Purpose Optimal treatment with antiepileptic drugs (AEDs) is an important part of care for brain tumor patients with epileptic seizures. Lamotrigine and lacosamide are both examples of frequently used non-enzyme inducing AEDs with limited to no drug-drug interactions, reducing the risk of unfavorabl...
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| Published in: | Journal of neuro-oncology 2021-08, Vol.154 (1), p.73-81 |
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| container_end_page | 81 |
| container_issue | 1 |
| container_start_page | 73 |
| container_title | Journal of neuro-oncology |
| container_volume | 154 |
| creator | van Opijnen, Mark P. van der Meer, Pim B. Dirven, Linda Fiocco, Marta Kouwenhoven, Mathilde C. M. van den Bent, Martin J. Taphoorn, Martin J. B. Koekkoek, Johan A. F. |
| description | Purpose
Optimal treatment with antiepileptic drugs (AEDs) is an important part of care for brain tumor patients with epileptic seizures. Lamotrigine and lacosamide are both examples of frequently used non-enzyme inducing AEDs with limited to no drug-drug interactions, reducing the risk of unfavorable side effects. This study aimed to compare the effectiveness of lamotrigine versus lacosamide.
Methods
In this multicenter study we retrospectively analyzed data of patients with diffuse grade 2–4 glioma with epileptic seizures. All patients received either lamotrigine or lacosamide during the course of their disease after treatment failure of first-line monotherapy with levetiracetam or valproic acid. Primary outcome was the cumulative incidence of treatment failure, from initiation of lamotrigine or lacosamide, with death as competing event, for which a competing risk model was used. Secondary outcomes were uncontrolled seizures after AED initiation and level of toxicity.
Results
We included a total of 139 patients of whom 61 (44%) used lamotrigine and 78 (56%) used lacosamide. At 12 months, there was no statistically significant difference in the cumulative incidence of treatment failure for any reason between lamotrigine and lacosamide: 38% (95%CI 26–51%) versus 30% (95%CI 20–41%), respectively. The adjusted hazard ratio for treatment failure of lacosamide compared to lamotrigine was 0.84 (95%CI 0.46–1.56). The cumulative incidences of treatment failure due to uncontrolled seizures (18% versus 11%) and due to adverse events (17% versus 19%) did not differ significantly between lamotrigine and lacosamide.
Conclusion
Lamotrigine and lacosamide show similar effectiveness in diffuse glioma patients with epilepsy. |
| doi_str_mv | 10.1007/s11060-021-03800-z |
| format | article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8367894</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2561653926</sourcerecordid><originalsourceid>FETCH-LOGICAL-c540t-c3ef9a0444f309bd614f88b78acdb79e7dc238c6ced0e7f544db66abe5a9a303</originalsourceid><addsrcrecordid>eNp9kcFu1TAQRS1ERR8tP8ACWWKdMo4dO2aBhCooSJXYvEV3luNMUleJE2znSfTrMX2lwIaVJc-ZO1c6hLxmcMEA1LvEGEiooGYV8Bagun9GdqxRvFJc8edkB0yqqtHi5pS8TOkOAITi7AU55YJpqZncEbe_RYrDgC77AwZMiS4DtSF7XP2Ea_aO9nEbaY5o84whUx_oOPlltnS1BQs5vaeTnZcc_egD0gPGtKXy5ZZkZ9_jOTkZ7JTw1eN7RvafP-0vv1TX366-Xn68rlwjIFeO46AtCCEGDrrrJRND23aqta7vlEbVu5q3TjrsAdXQCNF3UtoOG6stB35GPhxj162bsXelWbSTWaOfbfxhFuvNv5Pgb824HEzLpWq1KAFvHwPi8n3DlM3dssVQKpu6kUw2XNeyUPWRcnFJKeLwdIGB-eXFHL2Y4sU8eDH3ZenN392eVn6LKAA_AqmMwojxz-3_xP4ElxWdbg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2561653926</pqid></control><display><type>article</type><title>The effectiveness of antiepileptic drug treatment in glioma patients: lamotrigine versus lacosamide</title><source>Springer Link</source><creator>van Opijnen, Mark P. ; van der Meer, Pim B. ; Dirven, Linda ; Fiocco, Marta ; Kouwenhoven, Mathilde C. M. ; van den Bent, Martin J. ; Taphoorn, Martin J. B. ; Koekkoek, Johan A. F.</creator><creatorcontrib>van Opijnen, Mark P. ; van der Meer, Pim B. ; Dirven, Linda ; Fiocco, Marta ; Kouwenhoven, Mathilde C. M. ; van den Bent, Martin J. ; Taphoorn, Martin J. B. ; Koekkoek, Johan A. F.</creatorcontrib><description>Purpose
Optimal treatment with antiepileptic drugs (AEDs) is an important part of care for brain tumor patients with epileptic seizures. Lamotrigine and lacosamide are both examples of frequently used non-enzyme inducing AEDs with limited to no drug-drug interactions, reducing the risk of unfavorable side effects. This study aimed to compare the effectiveness of lamotrigine versus lacosamide.
Methods
In this multicenter study we retrospectively analyzed data of patients with diffuse grade 2–4 glioma with epileptic seizures. All patients received either lamotrigine or lacosamide during the course of their disease after treatment failure of first-line monotherapy with levetiracetam or valproic acid. Primary outcome was the cumulative incidence of treatment failure, from initiation of lamotrigine or lacosamide, with death as competing event, for which a competing risk model was used. Secondary outcomes were uncontrolled seizures after AED initiation and level of toxicity.
Results
We included a total of 139 patients of whom 61 (44%) used lamotrigine and 78 (56%) used lacosamide. At 12 months, there was no statistically significant difference in the cumulative incidence of treatment failure for any reason between lamotrigine and lacosamide: 38% (95%CI 26–51%) versus 30% (95%CI 20–41%), respectively. The adjusted hazard ratio for treatment failure of lacosamide compared to lamotrigine was 0.84 (95%CI 0.46–1.56). The cumulative incidences of treatment failure due to uncontrolled seizures (18% versus 11%) and due to adverse events (17% versus 19%) did not differ significantly between lamotrigine and lacosamide.
Conclusion
Lamotrigine and lacosamide show similar effectiveness in diffuse glioma patients with epilepsy.</description><identifier>ISSN: 0167-594X</identifier><identifier>EISSN: 1573-7373</identifier><identifier>DOI: 10.1007/s11060-021-03800-z</identifier><identifier>PMID: 34196916</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adverse events ; Anticonvulsants - therapeutic use ; Antiepileptic agents ; Brain cancer ; Brain tumors ; Clinical Study ; Convulsions & seizures ; Epilepsy ; Epilepsy - drug therapy ; Etiracetam ; Glioma ; Glioma - drug therapy ; Humans ; Lacosamide - adverse effects ; Lacosamide - therapeutic use ; Lamotrigine ; Lamotrigine - adverse effects ; Lamotrigine - therapeutic use ; Medicine ; Medicine & Public Health ; Neurology ; Oncology ; Patients ; Retrospective Studies ; Seizures ; Seizures - prevention & control ; Statistical analysis ; Toxicity ; Treatment Outcome ; Valproic acid</subject><ispartof>Journal of neuro-oncology, 2021-08, Vol.154 (1), p.73-81</ispartof><rights>The Author(s) 2021</rights><rights>2021. The Author(s).</rights><rights>The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c540t-c3ef9a0444f309bd614f88b78acdb79e7dc238c6ced0e7f544db66abe5a9a303</citedby><cites>FETCH-LOGICAL-c540t-c3ef9a0444f309bd614f88b78acdb79e7dc238c6ced0e7f544db66abe5a9a303</cites><orcidid>0000-0002-2400-4626</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,315,786,790,891,27957,27958</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34196916$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>van Opijnen, Mark P.</creatorcontrib><creatorcontrib>van der Meer, Pim B.</creatorcontrib><creatorcontrib>Dirven, Linda</creatorcontrib><creatorcontrib>Fiocco, Marta</creatorcontrib><creatorcontrib>Kouwenhoven, Mathilde C. M.</creatorcontrib><creatorcontrib>van den Bent, Martin J.</creatorcontrib><creatorcontrib>Taphoorn, Martin J. B.</creatorcontrib><creatorcontrib>Koekkoek, Johan A. F.</creatorcontrib><title>The effectiveness of antiepileptic drug treatment in glioma patients: lamotrigine versus lacosamide</title><title>Journal of neuro-oncology</title><addtitle>J Neurooncol</addtitle><addtitle>J Neurooncol</addtitle><description>Purpose
Optimal treatment with antiepileptic drugs (AEDs) is an important part of care for brain tumor patients with epileptic seizures. Lamotrigine and lacosamide are both examples of frequently used non-enzyme inducing AEDs with limited to no drug-drug interactions, reducing the risk of unfavorable side effects. This study aimed to compare the effectiveness of lamotrigine versus lacosamide.
Methods
In this multicenter study we retrospectively analyzed data of patients with diffuse grade 2–4 glioma with epileptic seizures. All patients received either lamotrigine or lacosamide during the course of their disease after treatment failure of first-line monotherapy with levetiracetam or valproic acid. Primary outcome was the cumulative incidence of treatment failure, from initiation of lamotrigine or lacosamide, with death as competing event, for which a competing risk model was used. Secondary outcomes were uncontrolled seizures after AED initiation and level of toxicity.
Results
We included a total of 139 patients of whom 61 (44%) used lamotrigine and 78 (56%) used lacosamide. At 12 months, there was no statistically significant difference in the cumulative incidence of treatment failure for any reason between lamotrigine and lacosamide: 38% (95%CI 26–51%) versus 30% (95%CI 20–41%), respectively. The adjusted hazard ratio for treatment failure of lacosamide compared to lamotrigine was 0.84 (95%CI 0.46–1.56). The cumulative incidences of treatment failure due to uncontrolled seizures (18% versus 11%) and due to adverse events (17% versus 19%) did not differ significantly between lamotrigine and lacosamide.
Conclusion
Lamotrigine and lacosamide show similar effectiveness in diffuse glioma patients with epilepsy.</description><subject>Adverse events</subject><subject>Anticonvulsants - therapeutic use</subject><subject>Antiepileptic agents</subject><subject>Brain cancer</subject><subject>Brain tumors</subject><subject>Clinical Study</subject><subject>Convulsions & seizures</subject><subject>Epilepsy</subject><subject>Epilepsy - drug therapy</subject><subject>Etiracetam</subject><subject>Glioma</subject><subject>Glioma - drug therapy</subject><subject>Humans</subject><subject>Lacosamide - adverse effects</subject><subject>Lacosamide - therapeutic use</subject><subject>Lamotrigine</subject><subject>Lamotrigine - adverse effects</subject><subject>Lamotrigine - therapeutic use</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neurology</subject><subject>Oncology</subject><subject>Patients</subject><subject>Retrospective Studies</subject><subject>Seizures</subject><subject>Seizures - prevention & control</subject><subject>Statistical analysis</subject><subject>Toxicity</subject><subject>Treatment Outcome</subject><subject>Valproic acid</subject><issn>0167-594X</issn><issn>1573-7373</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kcFu1TAQRS1ERR8tP8ACWWKdMo4dO2aBhCooSJXYvEV3luNMUleJE2znSfTrMX2lwIaVJc-ZO1c6hLxmcMEA1LvEGEiooGYV8Bagun9GdqxRvFJc8edkB0yqqtHi5pS8TOkOAITi7AU55YJpqZncEbe_RYrDgC77AwZMiS4DtSF7XP2Ea_aO9nEbaY5o84whUx_oOPlltnS1BQs5vaeTnZcc_egD0gPGtKXy5ZZkZ9_jOTkZ7JTw1eN7RvafP-0vv1TX366-Xn68rlwjIFeO46AtCCEGDrrrJRND23aqta7vlEbVu5q3TjrsAdXQCNF3UtoOG6stB35GPhxj162bsXelWbSTWaOfbfxhFuvNv5Pgb824HEzLpWq1KAFvHwPi8n3DlM3dssVQKpu6kUw2XNeyUPWRcnFJKeLwdIGB-eXFHL2Y4sU8eDH3ZenN392eVn6LKAA_AqmMwojxz-3_xP4ElxWdbg</recordid><startdate>20210801</startdate><enddate>20210801</enddate><creator>van Opijnen, Mark P.</creator><creator>van der Meer, Pim B.</creator><creator>Dirven, Linda</creator><creator>Fiocco, Marta</creator><creator>Kouwenhoven, Mathilde C. M.</creator><creator>van den Bent, Martin J.</creator><creator>Taphoorn, Martin J. B.</creator><creator>Koekkoek, Johan A. F.</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-2400-4626</orcidid></search><sort><creationdate>20210801</creationdate><title>The effectiveness of antiepileptic drug treatment in glioma patients: lamotrigine versus lacosamide</title><author>van Opijnen, Mark P. ; van der Meer, Pim B. ; Dirven, Linda ; Fiocco, Marta ; Kouwenhoven, Mathilde C. M. ; van den Bent, Martin J. ; Taphoorn, Martin J. B. ; Koekkoek, Johan A. F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c540t-c3ef9a0444f309bd614f88b78acdb79e7dc238c6ced0e7f544db66abe5a9a303</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adverse events</topic><topic>Anticonvulsants - therapeutic use</topic><topic>Antiepileptic agents</topic><topic>Brain cancer</topic><topic>Brain tumors</topic><topic>Clinical Study</topic><topic>Convulsions & seizures</topic><topic>Epilepsy</topic><topic>Epilepsy - drug therapy</topic><topic>Etiracetam</topic><topic>Glioma</topic><topic>Glioma - drug therapy</topic><topic>Humans</topic><topic>Lacosamide - adverse effects</topic><topic>Lacosamide - therapeutic use</topic><topic>Lamotrigine</topic><topic>Lamotrigine - adverse effects</topic><topic>Lamotrigine - therapeutic use</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neurology</topic><topic>Oncology</topic><topic>Patients</topic><topic>Retrospective Studies</topic><topic>Seizures</topic><topic>Seizures - prevention & control</topic><topic>Statistical analysis</topic><topic>Toxicity</topic><topic>Treatment Outcome</topic><topic>Valproic acid</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>van Opijnen, Mark P.</creatorcontrib><creatorcontrib>van der Meer, Pim B.</creatorcontrib><creatorcontrib>Dirven, Linda</creatorcontrib><creatorcontrib>Fiocco, Marta</creatorcontrib><creatorcontrib>Kouwenhoven, Mathilde C. M.</creatorcontrib><creatorcontrib>van den Bent, Martin J.</creatorcontrib><creatorcontrib>Taphoorn, Martin J. B.</creatorcontrib><creatorcontrib>Koekkoek, Johan A. F.</creatorcontrib><collection>Springer_OA刊</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest_Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database (Proquest)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of neuro-oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>van Opijnen, Mark P.</au><au>van der Meer, Pim B.</au><au>Dirven, Linda</au><au>Fiocco, Marta</au><au>Kouwenhoven, Mathilde C. M.</au><au>van den Bent, Martin J.</au><au>Taphoorn, Martin J. B.</au><au>Koekkoek, Johan A. F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The effectiveness of antiepileptic drug treatment in glioma patients: lamotrigine versus lacosamide</atitle><jtitle>Journal of neuro-oncology</jtitle><stitle>J Neurooncol</stitle><addtitle>J Neurooncol</addtitle><date>2021-08-01</date><risdate>2021</risdate><volume>154</volume><issue>1</issue><spage>73</spage><epage>81</epage><pages>73-81</pages><issn>0167-594X</issn><eissn>1573-7373</eissn><abstract>Purpose
Optimal treatment with antiepileptic drugs (AEDs) is an important part of care for brain tumor patients with epileptic seizures. Lamotrigine and lacosamide are both examples of frequently used non-enzyme inducing AEDs with limited to no drug-drug interactions, reducing the risk of unfavorable side effects. This study aimed to compare the effectiveness of lamotrigine versus lacosamide.
Methods
In this multicenter study we retrospectively analyzed data of patients with diffuse grade 2–4 glioma with epileptic seizures. All patients received either lamotrigine or lacosamide during the course of their disease after treatment failure of first-line monotherapy with levetiracetam or valproic acid. Primary outcome was the cumulative incidence of treatment failure, from initiation of lamotrigine or lacosamide, with death as competing event, for which a competing risk model was used. Secondary outcomes were uncontrolled seizures after AED initiation and level of toxicity.
Results
We included a total of 139 patients of whom 61 (44%) used lamotrigine and 78 (56%) used lacosamide. At 12 months, there was no statistically significant difference in the cumulative incidence of treatment failure for any reason between lamotrigine and lacosamide: 38% (95%CI 26–51%) versus 30% (95%CI 20–41%), respectively. The adjusted hazard ratio for treatment failure of lacosamide compared to lamotrigine was 0.84 (95%CI 0.46–1.56). The cumulative incidences of treatment failure due to uncontrolled seizures (18% versus 11%) and due to adverse events (17% versus 19%) did not differ significantly between lamotrigine and lacosamide.
Conclusion
Lamotrigine and lacosamide show similar effectiveness in diffuse glioma patients with epilepsy.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>34196916</pmid><doi>10.1007/s11060-021-03800-z</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-2400-4626</orcidid><oa>free_for_read</oa></addata></record> |
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| language | eng |
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| subjects | Adverse events Anticonvulsants - therapeutic use Antiepileptic agents Brain cancer Brain tumors Clinical Study Convulsions & seizures Epilepsy Epilepsy - drug therapy Etiracetam Glioma Glioma - drug therapy Humans Lacosamide - adverse effects Lacosamide - therapeutic use Lamotrigine Lamotrigine - adverse effects Lamotrigine - therapeutic use Medicine Medicine & Public Health Neurology Oncology Patients Retrospective Studies Seizures Seizures - prevention & control Statistical analysis Toxicity Treatment Outcome Valproic acid |
| title | The effectiveness of antiepileptic drug treatment in glioma patients: lamotrigine versus lacosamide |
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