Brivaracetam efficacy and tolerability in clinical practice: A UK-based retrospective multicenter service evaluation

Adewusi, Joy; Burness, Christine; Ellawela, Shan; Emsley, Hedley; Hughes, Rhiannon; Lawthom, Charlotte; Maguire, Melissa; McLean, Brendan; Mohanraj, Rajiv; Oto, Maria; Singhal, Sumeet; Reuber, Markus

doi:10.1016/j.yebeh.2020.106967

Cited by 27 publications

(38 citation statements)

References 34 publications

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“…The most frequently reported AEs pertaining to changes in behavior were irritability, depression, and anxiety, which were reported by 1% to 3% of the participants. These findings confirmed the overall favorable tolerability of adjunctive BRV and were consistent with the profile reported in randomized and nonrandomized studies 8–13 …”

Section: Discussionsupporting

confidence: 88%

“…Brivaracetam treatment was discontinued by around one‐fifth of the population. Despite differences in study methodology, the overall rate of withdrawal for adjunctive BRV was substantially consistent with those observed in several retrospective noninterventional studies, 9–12 but lower than the proportion reported by Steinhoff et al, probably due to the inclusion of patients with more severe epilepsies 13 . The main reason for drug withdrawal was lack of efficacy, and the number of lifetime ASMs was an independent predictor of retention time.…”

Section: Discussionsupporting

confidence: 79%

“…Furthermore, if the median time to event is 5 months, this means that one‐half of the patients had their seizure frequency reduced by at least 40%. These figures substantially prove the efficacy of BRV to control seizures when added to the pre‐existing therapeutic regimen in everyday clinical practice and expand from a novel perspective the available findings 8–13 …”

Section: Discussionmentioning

confidence: 60%

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Brivaracetam as add‐on treatment in focal epilepsy: A real‐world time‐based analysis

et al. 2020

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The study assessed the clinical response to add‐on brivaracetam (BRV) in real‐world practice by means of time‐to‐baseline seizure count methodology. Patients with focal epilepsy who were prescribed add‐on BRV were identified. Primary endpoint was the time‐to‐baseline seizure count defined as the number of days until each patient experienced the number of focal seizures that occurred in the 90 days before BRV initiation. Subgroup analysis was performed according to levetiracetam (LEV) status (naive vs prior use). Three‐hundred eighty‐seven patients were included. The overall median time‐to‐baseline seizure count was 150 (95% confidence interval [CI] = 130‐175) days. The median time‐to‐baseline seizure count was 198 (lower limit of 95% CI = 168) days for LEV‐naive patients, 126 (95% CI = 105‐150) days for patients with prior LEV use and withdrawal due to insufficient efficacy, and 170 (95% CI = 128‐291) days for patients who discontinued LEV due to adverse events (P = .002). The number of prior antiseizure medications (adjusted hazard ratio [adjHR] = 1.07, 95% CI = 1.02‐1.13, P = .009) and baseline monthly seizure frequency (adjHR = 1.004, 95% CI = 1.001‐1.008, P = .028) were independently associated with the primary endpoint. Add‐on BRV improved seizure control in LEV‐naive and LEV‐prior patients. The time‐to‐baseline seizure count represents an informative endpoint alongside traditional study outcomes and designs.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 60%

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Brivaracetam as add‐on treatment in focal epilepsy: A real‐world time‐based analysis

et al. 2020

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“…A great response was achieved among the patients affected by Jeavons syndrome (90% reduction of seizures) such that they were switched to monotherapy. A similar outcome was found in a cohort of adult patients with generalized pharmaco‐resistant epilepsy where BRV was used off‐label in monotherapy, achieving a clinically significant improvement in the number of seizures 33 …”

Section: Comparative Efficacysupporting

confidence: 73%

“…Nissenkorn et al 29 included 5 patients with Lennox‐Gastaut syndrome (LGS), 3 with Jeavons syndrome and 3 with myoclonic‐atonic epilepsy in his cohort. In the group of patients with LGS, 33 2 out of 5 responded to BRV, while seizure aggravation was reported in 2 patients. A great response was achieved among the patients affected by Jeavons syndrome (90% reduction of seizures) such that they were switched to monotherapy.…”

Section: Comparative Efficacymentioning

confidence: 92%

Potential role of brivaracetam in pediatric epilepsy

et al. 2020

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Brivaracetam (BRV), which is considered to be the second generation of the drug of levetiracetam (LEV), 1 is a new antiseizure medication (ASM). It is a 2S)-2-[(4R)-2-oxo-4-propylpyrrolidin-1-yl] butanamide with four different diastereomers 2 capable of binding to SV2A vesicles with high affinity. 3 It was discovered as part of a program established by UCB Pharma to identify selective, high-affinity SV2A ligands that have higher antiepileptic properties than LEV. 2,4,5 Brivaracetam has a 10-30 times greater affinity and selectivity than LEV 6,7 and, compared to the latter, shows greater permeability of the blood-brain barrier in rodent models. 8 In recent years, it has been tested as an ASM in adult and pediatric patients. Most of the studies on the tolerability and efficacy of BRV concern the adult population; the data on the pediatric population are still sparse. The purpose of this review is to provide a comprehensive overview of the available data published about its efficacy and tolerability at the pediatric age.

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Rapid switching from levetiracetam to brivaracetam in pharmaco-resistant epilepsy in people with and without intellectual disabilities: a naturalistic case control study

Watkins,

Dunstall,

Musicha

et al. 2023

J Neurol

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Brivaracetam efficacy and tolerability in clinical practice: A UK-based retrospective multicenter service evaluation

Cited by 27 publications

References 34 publications

Brivaracetam as add‐on treatment in focal epilepsy: A real‐world time‐based analysis

Brivaracetam as add‐on treatment in focal epilepsy: A real‐world time‐based analysis

Potential role of brivaracetam in pediatric epilepsy

Rapid switching from levetiracetam to brivaracetam in pharmaco-resistant epilepsy in people with and without intellectual disabilities: a naturalistic case control study

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