Efficacy, retention, and tolerability of Brivaracetam in patients with epileptic encephalopathies : a multicenter cohort study from Germany

  • Objective: To evaluate the efficacy and tolerability of brivaracetam (BRV) in a severely drug refractory cohort of patients with epileptic encephalopathies (EE). Method: A multicenter, retrospective cohort study recruiting all patients treated with EE who began treatment with BRV in an enrolling epilepsy center between 2016 and 2017. Results: Forty-four patients (27 male [61%], mean age 29 years, range 6 to 62) were treated with BRV. The retention rate was 65% at 3 months, 52% at 6 months and 41% at 12 months. A mean retention time of 5 months resulted in a cumulative exposure to BRV of 310 months. Three patients were seizure free during the baseline. At 3 months, 20 (45%, 20/44 as per intention-to-treat analysis considering all patients that started BRV including three who were seizure free during baseline) were either seizure free (n = 4; 9%, three of them already seizure-free at baseline) or reported at least 25% (n = 4; 9%) or 50% (n = 12; 27%) reduction in seizures. An increase in seizure frequency was reported in two (5%) patients, while there was no change in the seizure frequency of the other patients. A 50% long-term responder rate was apparent in 19 patients (43%), with two (5%) free from seizures for more than six months and in nine patients (20%, with one [2 %] free from seizures) for more than 12 months. Treatment-emergent adverse events were predominantly of psychobehavioural nature and were observed in 16%. Significance: In this retrospective analysis the rate of patients with a 50% seizure reduction under BRV proofed to be similar to those seen in regulatory trials for focal epilepsies. BRV appears to be safe and relatively well tolerated in EE and might be considered in patients with psychobehavioral adverse events while on levetiracetam.

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Author:Laurent Maximilian WillemsORCiDGND, Astrid Bertsche, Frank Bösebeck, Frauke Hornemann, Ilka ImmischGND, Karl Martin Klein, Susanne KnakeORCiDGND, Rhina Kunz, Gerhard KurlemannGND, Lisa Langenbruch, Gabriel Möddel, Karen Müller-SchlüterGND, Felix von PodewilsORCiDGND, Philipp Sebastian Reif, Bernhard J. Steinhoff, Isabel Steinig, Felix RosenowORCiDGND, Susanne Schubert-BastORCiDGND, Adam StrzelczykORCiDGND
Pubmed Id:https://pubmed.ncbi.nlm.nih.gov/30083127
Parent Title (English):Frontiers in neurology
Publisher:Frontiers Research Foundation
Place of publication:Lausanne
Contributor(s):Fernando Cendes
Document Type:Article
Year of Completion:2018
Date of first Publication:2018/07/23
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2018/10/30
Tag:anticonvulsants; epilepsy; epileptic encephalopathies; levetiracetam; seizure
Issue:Art. 569
Page Number:8
First Page:1
Last Page:8
Copyright © 2018 Willems, Bertsche, Bösebeck, Hornemann, Immisch, Klein, Knake, Kunz, Kurlemann, Langenbruch, Möddel, Müller-Schlüter, von Podewils, Reif, Steinhoff, Steinig, Rosenow, Schubert-Bast and Strzelczyk. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Institutes:Biochemie, Chemie und Pharmazie / Pharmazie
Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 4.0