Postmarketing experience with brivaracetam in the treatment of epilepsies: A multicenter cohort study from Germany

Abstract

BRV in broad clinical postmarketing use is a well-tolerated anticonvulsant drug with 50% responder rates, similar to those observed in the regulatory trials, even though 90% of the patients included had previously been exposed to LEV. An immediate switch from LEV to BRV at a ratio of 10:1 to 15:1 is feasible. The only independent significant predictor of efficacy was the start of BRV in patients not currently taking LEV. The occurrence of BAE during previous LEV exposure predicted poor psychobehavioral tolerability of BRV treatment. A switch to BRV can be considered in patients with LEV-induced BAE.

BRIVA-LIFE-A multicenter retrospective study of the long-term use of brivaracetam in clinical practice

“…These results are in keeping with findings of the three aforementioned retrospective series, [9][10][11] and with those of a meta-analysis, which found BRV, LEV, and gabapentin to have the best tolerability profiles among newer AEDs. These results are in keeping with findings of the three aforementioned retrospective series, [9][10][11] and with those of a meta-analysis, which found BRV, LEV, and gabapentin to have the best tolerability profiles among newer AEDs.…”

“…[9][10][11] In two, 101 and 93 patients with focal epilepsy (both 97%), who had failed 10 (median) and 6.3 A sig- These findings are generally consistent with those of other retrospective series.…”

“…18 The higher incidence in this study is likely due to the large proportion of patients with psychiatric comorbidity (44.2%)-such patients are typically excluded from RCTs. 9,14 More patients who switched overnight experienced seizure worsening than those who transitioned progressively (8.1% vs 6.9%). Titration, therefore, could be avoided for patients at high risk of breakthrough seizures and accidents, or those experiencing severe AEs requiring rapid AED replacement.…”

Behavioural changes in patients with intellectual disability treated with brivaracetam

“…[6][7][8]14 A retrospective study analysing the efficacy and tolerability of brivaracetam under real-world conditions revealed a responder rate of 27.8% with 7% seizure-free patients. 16 The higher potency of brivaracetam compared with levetiracetam has been proven with in vitro and in vivo models of seizures and epilepsy. 16 The higher potency of brivaracetam compared with levetiracetam has been proven with in vitro and in vivo models of seizures and epilepsy.…”

Exceptional response to brivaracetam in a patient with refractory idiopathic generalized epilepsy and absence seizures

“…However, BRV has been suggested to provide broad-spectrum efficacy given its similarity to LEV and based on the results from preclinical studies on animals (Matagne et al, 2008) and other reports of patients with genetic generalized epilepsy (Kasteleijn-Nolst Trenite et al, 2007;Kwan et al, 2014;Steinig et al, 2017). This situation is especially frequent in patients with generalized epilepsy, for whom very few pharmacological treatment options are available and surgery is not considered.…”