Levetiracetam and Valproate Retention Rate in Juvenile Myoclonic Epilepsy

Sala-Padró, Jacint; Toledo, Manuel; Santamarina, Estevo; González-Cuevas, Montserrat; Raspall-Chaure, Miquel; Sueiras-Gil, María; Quintana, Manuel; Salas‐Puig, Xavier

doi:10.1097/wnf.0000000000000177

Cited by 12 publications

(7 citation statements)

References 9 publications

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“…This study confirmed that LEV had a certain effect on patients with JME. Although VPA had a better effect on GTCS control, which was consistent with another study, a recent study found that LEV and VPA showed similar retention rates, and LEV showed a good trend for MS control (36.7% [18/49] for VPA, 63.6% [14/22] for LEV, log rank P = 0.085) . In addition, a study reported the efficacy of LEV in GGE with MS .…”

Section: Discussionsupporting

confidence: 82%

“…Although VPA had a better effect on GTCS control, which was consistent with another study, 23 a recent study found that LEV and VPA showed similar retention rates, and LEV showed a good trend for MS control (36.7% [18/49] for VPA, 63.6% [14/22] for LEV, log rank P = 0.085). 24 In addition, a study reported the efficacy of LEV in GGE with MS. 25 Some studies also reported a good efficacy and tolerability profile for LEV in the treatment of JME. 26,27 Above all, LEV may be a better option for women with JME in view of the side effects of VPA.…”

Section: Discussionmentioning

confidence: 99%

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Clinical features and treatment outcomes of Juvenile myoclonic epilepsy patients

et al. 2019

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Objective The aim of this study was to evaluate the clinical features and treatment outcomes of patients with juvenile myoclonic epilepsy ( JME ) in western China. Method We continuously reviewed one hundred and five outpatients with JME who were diagnosed and treated at the Epilepsy Registration Center of West China Hospital between October 2012 and July 2014. Seizure control stratified into different seizure types and by antiepileptic drugs ( AED s) was prospectively evaluated every 3‐6 months. Results Among 105 patients with JME , eighty‐five patients (81%) received monotherapy including valproate ( VPA , 47%) and levetiracetam ( LEV , 43%) treatment. The rates of seizure freedom 1, 3, and 5 years after the initiation of AED treatment were 64.8% (68/105), 29.5% (31/105), and 14.6% (12/82) in JME patients, respectively. Patients with myoclonic seizure ( MS ) and absence seizure ( AS ) were less frequently seizure‐free than those with MS and generalized tonic‐clonic seizure ( GTCS ) ( P = 0.012). Patients on VPA monotherapy had better control of GTCS than patients on LEV monotherapy ( P = 0.036). There is a trend of lower rates of seizure freedom in patients treated with LEV than in those treated with VPA after the first‐year treatment period . Significance Our data suggest that in JME , seizure control is linked to seizure type, possibly allowing a more individualized approach when counseling JME patients.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Clinical features and treatment outcomes of Juvenile myoclonic epilepsy patients

et al. 2019

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“…Postmarketing studies of BRV in predominantly focal epilepsies showed comparable retention rates of 51.5%, 72%, and 75.8% at 6 months . In GGE, sufficient data on retention rates are available for LTG, VPA, and LEV; with the highest retention rates for VPA in all GGE subsyndromes (90% at 3 years), followed by LEV (65% at 3 years; only juvenile myoclonic epilepsy) and LTG (45% at 3 years) …”

Section: Discussionmentioning

confidence: 91%

“…[38][39][40] In GGE, sufficient data on retention rates are available for LTG, VPA, and LEV; with the highest retention rates for VPA in all GGE subsyndromes (90% at 3 years), followed by LEV (65% at 3 years; only juvenile myoclonic epilepsy) and LTG (45% at 3 years). 46,47 Different factors point to BRV's potential as an alternative compound for treatment of SE. BRV is available as an intravenous solution and licensed for bolus injection.…”

Section: Discussionmentioning

confidence: 99%

Use of brivaracetam in genetic generalized epilepsies and for acute, intravenous treatment of absence status epilepticus

et al. 2018

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“…Sodium valproate (VPA) and levetiracetam (LEV) are extensively used anti-epileptic drugs in clinical practice, and both have satisfactory therapeutic effects and safety [22,23]. VPA plays an anti-epileptic role, mainly by enhancing the inhibitory neurotransmitter gamma aminobutyric acid (GABA) [24], and LEV plays an anti-epileptic role by combining synaptophysin with synaptic vesicle protein 2A (SV2A) [25].…”

Section: Introductionmentioning

confidence: 99%

Levetiracetam Protects Against Cognitive Impairment of Subthreshold Convulsant Discharge Model Rats by Activating Protein Kinase C (PKC)-Growth-Associated Protein 43 (GAP-43)-Calmodulin-Dependent Protein Kinase (CaMK) Signal Transduction Pathway

Wang

Jiang²,

Chen

et al. 2019

Med Sci Monit

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Background Subclinical epileptiform discharges (SEDs) are defined as epileptiform electroencephalographic (EEG) discharges without clinical signs of seizure in patients. The subthreshold convulsant discharge (SCD) is a frequently used model for SEDs. This study aimed to investigate the effect of levetiracetam (LEV), an anti-convulsant drug, on cognitive impairment of SCD model rats and to assess the associated mechanisms. Material/Methods A SCD rat model was established. Rats were divided into an SCD group, an SCD+ sodium valproate (VPA) group, and an SCD+ levetiracetam (LEV) group. The Morris water maze was used to evaluate the capacity of positioning navigation and space exploration. The field excitatory post-synaptic potentials (fEPSPs) were evaluated using a bipolar stimulation electrode. NCAM, GAP43, PS95, and CaMK II levels were detected using Western blot and RT-PCR, respectively. PKC activity was examined by a non-radioactive method. Results LEV shortens the latency of platform seeking in SCD rats in positioning navigation. fEPSP slopes were significantly lower in the SCD group, and LEV treatment significantly enhanced the fEPSP slopes compared to the SCD group ( P <0.05). The NCAM and GAP-43 levels were increased and PSD-95 levels were increased in SCD rats ( P <0.05), which were improved by LEV treatment. The PKC activity and CaMK II levels were decreased in SCD rats and LEV treatment significantly enhanced PKC activity and increased CaMK II levels. Conclusions Cognitive impairment in of SCD model rats may be caused by decreased PKC activity, low expression of CaMK II, and inhibition of LTP formation. LEV can improve cognitive function by activating the PKC-GAP-43-CaMK signal transduction pathway.

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Levetiracetam and Valproate Retention Rate in Juvenile Myoclonic Epilepsy

Cited by 12 publications

References 9 publications

Clinical features and treatment outcomes of Juvenile myoclonic epilepsy patients

Clinical features and treatment outcomes of Juvenile myoclonic epilepsy patients

Use of brivaracetam in genetic generalized epilepsies and for acute, intravenous treatment of absence status epilepticus

Levetiracetam Protects Against Cognitive Impairment of Subthreshold Convulsant Discharge Model Rats by Activating Protein Kinase C (PKC)-Growth-Associated Protein 43 (GAP-43)-Calmodulin-Dependent Protein Kinase (CaMK) Signal Transduction Pathway

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