Efficacy and Safety of Brivaracetam as First and Second Add-On Therapy in Adult Patients with Epilepsy
Abstract number :
3.297
Submission category :
7. Anti-seizure Medications / 7D. Drug Side Effects
Year :
2021
Submission ID :
1826030
Source :
www.aesnet.org
Presentation date :
12/6/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:51 AM
Authors :
Laura Abraira del Fresno, MD, PhD - Vall d'Hebron University Hospital. Barcelona. Spain; Elena Fonseca Hernández - Epilepsy Unit, Neurology department, Vall d'Hebron University Hospital; Manuel Quintana Luque - Epilepsy Unit, Neurology department, Vall d'Hebron University Hospital; Thomas Medina - School of Medicine, Universidad de los Andes, Bogotá, Colombia; Estevo Santamarina Pérez - Epilepsy Unit, Neurology department, Vall d'Hebron University Hospital; Manuel Toledo Argany - Epilepsy Unit, Neurology department, Vall d'Hebron University Hospital
Rationale: Brivaracetam (BRV) has demonstrated to be an effective add-on treatment in focal-onset seizures. The aim of this study is to show real life evidence on the efficacy and safety as early add-on treatment in adult patients with focal and generalized genetic epilepsy, the formerly Idiopathic Generalized Epilepsy (IGE).
Methods: We performed a retrospective longitudinal study including adult patients with focal and IGE in which BRV was started as first- or second add-on or consecutive monotherapy with at least a 6-month follow-up. Seizure frequency during the 6-month period before and after starting treatment was obtained from medical records. We evaluated responder rates (seizure frequency reduction of ≥50%), retention rate and adverse events (AE).
Results: Eighty-two patients were included (mean age 47.8±20.9 years; 54.9% women), 4 lost to follow-up. Focal epilepsy represented 75.6% of patients. Unknown cause (26.8%), vascular (26.8%) and hippocampal sclerosis (6.1%) were the most frequent etiologies. BRV was started as first add-on in 29.3% and as second-line monotherapy in 70.7%. Motivation to start BRV was adverse events (AE) in 58.5% and inefficacy of previous antiseizure medication (ASM) 20.7%. Median BRV starting dose was 100mg/day. Median baseline seizure frequency was 2±5.2 seizures/month. At 6-month follow up retention rate was 95% for IGE and 85.5% for focal epilepsy. Responder rate was 94.4% for IGE (83.3% were seizure-free) and 81.7% for focal epilepsy (63.3% were seizure-free). Starting BRV due to AE of previous ASM (p < 0.001), shorter duration of epilepsy (p=0.007) and an older age of epilepsy onset (p=0,031) were associated with better responder rates. AE were reported by 37.2% patients. Treatment discontinuation occurred in 10 patients, due to AE (7), inefficacy (2) or both (1).
Anti-seizure Medications