TY  - JOUR
A1  - Lerche, Holger
A1  - Knake, Susanne
A1  - Rosenow, Felix
A1  - Schulze‐Bonhage, Andreas
A1  - Hellot, Scarlett
A1  - Leunikava, Iryna
A1  - Schulz, Anne‐Liv
A1  - Hopp, Peter
T1  - Brivaracetam substituting other antiepileptic treatments: Results of a retrospective study in German epilepsy centers
T2  - Epilepsia Open
N2  - Objective To evaluate the success of initiation of adjunctive brivaracetam in patients who required a change in antiepileptic drug (AED) regimen and substituted at least one AED with brivaracetam. Methods In this retrospective noninterventional study conducted in specialized epilepsy centers across Germany, patients initiated adjunctive brivaracetam between February 15, 2016, and August 31, 2016, as part of an intended change in AED regimen. The primary effectiveness variable was the proportion of patients who continued on brivaracetam after 3 months, and withdrew at least one AED either before or within 6 months after brivaracetam initiation. Results Five hundred and six patients had at least one brivaracetam dose and were included in the safety set (SS). Four hundred and seventy patients started to reduce the dose of one AED before/after brivaracetam initiation, had at least one concomitant AED at brivaracetam initiation, and were included in the full analysis set (FAS) for effectiveness analyses. At baseline, patients had a median of seven lifetime AEDs and a median of 3.8 seizures/28 days. In the SS, 85.2% of patients withdrew one AED before/after initiation of brivaracetam, most commonly levetiracetam (49.4%). 46.2% of patients substituted another AED with brivaracetam within 24 hours (fast withdrawal). The proportions of patients (FAS) who continued on brivaracetam after 3 and 6 months and withdrew one AED were 75.5% and 46.6%, respectively. After 6 months, 32.1% of patients were 50% responders; 13.0% were seizure‐free. In the SS, 34.6% of patients reported treatment‐emergent adverse events (TEAEs); 21.9% had TEAEs that were assessed by the treating physician as drug‐related. Incidences of behavioral AEs before (3‐month baseline) and after brivaracetam initiation in patients who withdrew levetiracetam were 19.2% and 8.0%, respectively (5.0% and 7.7% in patients who withdrew other AEDs). Significance Brivaracetam was effective and well‐tolerated in patients who required a change in AED drug regimen and initiated adjunctive brivaracetam in German clinical practice.
KW  - antiseizure
KW  - behavioral adverse events
KW  - drug‐resistant epilepsy
KW  - focal seizures
KW  - noninterventional
Y1  - 2020
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/55976
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-559768
SN  - 2470-9239
VL  - 5
IS  - 3
SP  - 451
EP  - 460
PB  - Wiley
CY  - Hoboken, NJ
ER  -