Brivaracetam Effective for Reducing Seizures in Patients with Epileptic Encephalopathies

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Although 2 patients experienced an increase in seizure frequency, the remaining patients did not experience a change in frequency.
Although 2 patients experienced an increase in seizure frequency, the remaining patients did not experience a change in frequency.

In a study published in the Frontiers of Neurology, antiepileptic drug brivaracetam was safe and well-tolerated in patients with epileptic encephalopathies (EE).

Data from patients with EE who received ≥1 BRV dose at 8 epilepsy centers were retrospectively reviewed (n=44). Baseline seizure frequency was defined as the mean seizure frequency over the previous 3 months prior to BRV treatment initiation. Retention rates at 3, 6, and 12 months were calculated. The study investigators defined terminal remission as patients who achieved seizure freedom throughout each follow-up period.

Non-responders to therapy were patients who experienced a <25% seizure reduction following treatment. Conversely, patients with a 50% responder rate were defined as individuals achieving a >50% reduction in seizure frequency.

At 3, 6, and 12 months, the retention rates were 65%, 52%, and 41%, respectively. Overall, the cumulative total BRV exposure was 310 months. At 3-month follow-up, a total of 20 patients achieved seizure freedom or reductions in seizure frequency.

Although 2 patients experienced an increase in seizure frequency, the remaining patients did not. Approximately 43% (n=19) of patients had a 50% long-term responder rate, with 2 and 9 of these patients achieving seizure freedom for >6 months and >12 months, respectively. Psycho-behavioral adverse events, including somnolence and bruxism, were noted in approximately 16% of participants.

Limitations of the analysis include its retrospective nature, reliance on interviews for treatment-emergent adverse event reporting, and the relatively small sample size.

The researchers added that the effectiveness “of BRV does not seem to depend on whether patients have previously been exposed to levetiracetam or not.”

Reference

Willems LM, Bertsche A, Bösebeck F, et al. Efficacy, retention, and tolerability of brivaracetam in patients with epileptic encephalopathies: a multicenter cohort study from germany. Front Neurol. 2018;9:569.

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