Abstracts

Use of a single [underline]broad-spectrum [/underline]antiepileptic drug (AED) that is both efficacious and safe is optimal in epileptic patients. An AED displaying these properties and given as a first-line agent could eliminate [underline]trial and error of[/underline] multiple therapies which often must be tried before the most effective therapy is determined. Levetiracetam (LEV) has previously shown efficacy and safety when used as monotherapy., Single-center, retrospective review of 98 epileptic patients (69 females, 29 males; mean age 39.5 years, rage 15-75 years) who were treated with LEV monotherapy over a one-year period. Medical records were reviewed for seizure type and etiology, history of prior AED use, imaging results, and LEV dosage. Efficacy and tolerability were assessed by reduction in seizure frequency and by reported adverse effects., The most common seizure types were generalized (n=49) and complex partial (with or without secondary generalization, n=45). Fifty-one patients (52%) were given LEV as the first-line AED; 34 wre taking 1 AED and 13 were taking 2 AEDs at study initiation. The most frequently used AEDs included divalproex sodium (11%) and phenytoin (9%). LEV dosage was 3000 mg/day in 46 patients (47%) and 1500 mg/day in 36 (37%); titration to this dosage occurred over 1 week. The mean seizure reduction rate was 87.3%, with 53 patients becoming seizure free. An overall responder rate ([ge]50% seizure reduction) of 95% was noted. Thirty-four patients (35%) were able to discontinue 1 or more AEDs and were converted to LEV monotherapy. Clinical impression was good or excellent in 83 patients (85%).
Of patients given LEV as first-line monothrapy, a mean seizure reduction of 87.6% was noted, with 32 patients becoming seizure free. The responder rate in the sub-group was 94% with 44 patients with a good or excellent clinical impression.
Adverse events were reported in 7 patients overall (7%); 3 required discontinuation for itching/rash (1), dizziness/ataxia (1) or nausea (1)., LEV showed excellent efficacy and tolerability in this group of patients when used as monotherapy. Further studies should explore the use of LEV in monotherapy, particularly as a first-line agent., (Supported by UCB Pharma, Inc.)