Levetiracetam extended release for the treatment of patients with partial-onset seizures: A long-term, open-label follow-up study

Chung, Steve S.; Ceja, Hugo; Gawłowicz, Jacek; McShea, Cindy; Schiemann, Jimmy; Lu, Sarah

doi:10.1016/j.eplepsyres.2015.11.017

Cited by 8 publications

(8 citation statements)

References 12 publications

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“…15,16 An open label study concluded that levetiracetam XR was well tolerated when administered as long-term monotherapy or in combination with other AEDs in patients with inadequately controlled partial onset seizures. 17 Zonisamide was reported to achieves seizure freedom in more than 80% of patients with new-onset focal epilepsy and up to 18.1% of patients with focal onset seizures inadequately controlled by first-line anticonvul-sant. 1,18 An expert opinion survey in 2016 showed lamotrigine, levetiracetam, and oxcarbazepine were considered drugs of choice for initial treatment of focal seizures.…”

Section: Appropriate Choice Of Antiepileptic Drugs: a Discussionmentioning

confidence: 99%

Medical Management in Focal versus Generalized Epilepsy

Sannagowdara

Khan

2021

Journal of Pediatric Epilepsy

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About 70% of children with new-onset epilepsy have the potential to become seizure-free on antiepileptic drug (AED) monotherapy with appropriately selected first-line medication. In ideal world, physician is expected to achieve best possible seizure control without impacting the quality of life. There is rapid increase in number of AEDs available over last couple of decades. Although not necessarily all of them are superior to old generation drugs in terms of seizure control, certainly there is change in landscape from perspective of tolerability and side-effect profile. Physicians must therefore be familiar with safety, tolerability, therapeutic effects, synergistic combinations as well as AEDs to avoid in specific circumstances. The article attempts to give general overview of available AEDs under broad umbrella of effectiveness against focal and generalized seizures as well as drugs with “broad spectrum.” The emergence of newer AEDs with broad spectrum and favorable side-effect profile is welcome. However, the future lies in better understanding of underlying diverse pathophysiology of clinical symptom “epilepsy” and developing new compounds acting on molecular targets as well as individualizing therapy. Technological advances in molecular genetics research are bringing precision medicine to the fore.

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Section: Appropriate Choice Of Antiepileptic Drugs: a Discussionmentioning

confidence: 99%

Medical Management in Focal versus Generalized Epilepsy

Sannagowdara

Khan

2021

Journal of Pediatric Epilepsy

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“…29 In another 1-year safety study in patients from all age groups with refractory partial-onset seizure, Levetiracetam extended-release monotherapy demonstrated a retention rate of 65.3% and 47.1% at 12-and 18-months, with a low discontinuation rate (2.6%) and in most of the patients, mild-to-moderate TEAEs reported. 72 Treatment of geriatric group has unique challenges, due to age-related decreased metabolism and slowed down renal clearance. This results in a reduced therapeutic window and decreased tolerability to the therapy.…”

Section: Clinical Evidence-safetymentioning

confidence: 99%

Recent updates on Levetiracetam

Panchal¹,

Uppal²,

Uppal³

2022

IJN

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To review recent clinical evidence available for levetiracetam in the treatment of various types of epileptic seizures. A literature search was conducted to identify clinical studies conducted after 2015 with Levetiracetam. In patients with focal epilepsy, Levetiracetam was found to be as effective as Carbamazepine, Clobazam, and Valproic acid but with better tolerability than Carbamazepine. Levetiracetam could be used as monotherapy in the treatment of new-onset focal epilepsy. It probably has a neuroprotective benefit, particularly important in neonates and children. The safety and tolerability of Levetiracetam are more apparent during pregnancy. Thus, the adverse event profile is largely in favor of Levetiracetam in comparison to standard older AEDs. Meta-analysis has confirmed that Levetiracetam is significantly better in terms of withdrawal rates compared to the older AEDs, hence may be considered as the first line in new-onset focal epilepsy in adults and the elderly. Levetiracetam may be a better option as an add-on treatment in children with partial seizures, due to its favorable efficacy and insignificant toxicity than Oxcarbazepine and Topiramate. Recent evidence suggests that Levetiracetam could be a potential first-choice, second-line AED for Benzodiazepine resistance status epilepticus with efficacy comparable to established older AEDs. It improves the quality of life due to higher rates of seizure freedom and favorable tolerability profile. Levetiracetam has the potential for being a first-line AED and has also proven to be a better adjunctive considering the recent efficacy and safety outcomes.

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“…2 This list excludes extended release formulations, vagus nerve stimulation technology, and dietary modifications. 3,4 The conventional AEDs include phenytoin, carbamazepine, valproic acid, ethosuximide, and newer include zonisamide, lamotrigine, levetiracetam, lacosamide. None of the newer AEDs have been found better than the conventional.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of differences in health-related quality of life in patients receiving conventional versus newer anti-epileptic drugs

Goswami

Rana

Shah

et al. 2020

Int J Basic Clin Pharmacol

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Background: Epilepsy is associated with stigma and bad health-related quality of life (HR-QOL) due to this, and side effects of the drug therapy. Newer anti-epileptics are claimed to be better than the conventional. We evaluated this based on comparison of HR-QOL in patients taking the respective therapy.Methods: An observational, cross-sectional, single point study involved 127 consenting patients from Neurology OPD at V.S. General Hospital. Quality of life in epilepsy-10 (QOLIE-10) questionnaire was used to measure HR-QOL in patients. SPSS software and Graphpad prism were used to analyze the variables.Results: Patients of 20-30 age group were commonly affected (37.80%) with a male predominance (56.69%). 41.73% were unemployed. The difference in HR-QOL between patients and controls in all three domains (epilepsy effects, mental effects, role function domains) of QOLIE-10 was significant (p=0.0002), indicating better HR-QOL in controls. The worst HR-QOL scores were found in Epilepsy effects domain. Metabolic adverse effects (38.58%) were the common ADRs. Sodium valproate was the most effective in controlling seizures (last seizure episode: 15 months). HR-QOL correlation between patients receiving monotherapy and polytherapy was significant (p=0.026) with monotherapy rendering a better HR-QOL. Comparison of HR-QOL between patients taking the conventional and the newer drugs was not significant (p=0.1768).Conclusions: Our study nullifies the claims that newer drugs are better than the conventional since no such benefit was seen in HR-QOL as well as ADRs. Our findings ruled out the belief that cases of epilepsy are better controlled with polytherapy.

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Levetiracetam extended release for the treatment of patients with partial-onset seizures: A long-term, open-label follow-up study

Cited by 8 publications

References 12 publications

Medical Management in Focal versus Generalized Epilepsy

Medical Management in Focal versus Generalized Epilepsy

Recent updates on Levetiracetam

Evaluation of differences in health-related quality of life in patients receiving conventional versus newer anti-epileptic drugs

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