LONG-TERM RETENTION AND EFFICACY OF LEVETIRACETAM IN A LARGE COHORT OF PATIENTS WITH CHRONIC EPILEPSY
Abstract number :
1.315
Submission category :
Year :
2004
Submission ID :
4343
Source :
www.aesnet.org
Presentation date :
12/2/2004 12:00:00 AM
Published date :
Dec 1, 2004, 06:00 AM
Authors :
1Chantal Depondt, 2Alan W.C. Yuen, 1Marco Mula, 1,2Rebecca S.N. Liu, 1,2Tejal N. Mitchell, 2Gail S. Bell, and 1,2Josemir W. Sander
To determine the long-term retention rate and outcome of treatment with levetiracetam (LEV) in patients with chronic epilepsy. Patients with chronic epilepsy attending a tertiary referral centre for epilepsy were prospectively enrolled in this evaluation if they had LEV started within the first 24 months post-marketing of LEV in the United Kingdom. The following variables were analysed: retention rate of LEV at last follow-up; LEV dosage; percentage of patients achieving seizure freedom; percentage of patients achieving [ge]50% seizure reduction; percentage of patients discontinuing LEV and reasons for discontinuation. Eight hundred and eleven patients (49% male), aged 14 to 79 years (mean 37 years), were included in the study. Longest duration of follow-up was 41 months. At last follow-up, 528 patients (65%) were continuing on LEV, of whom 426 (81%) had follow-up of 12 months or longer. LEV dosages at last follow-up ranged from 125 to 5000 mg/day (median 2000 mg/day). One hundred and forty three patients (18%) attained seizure freedom at any time during treatment, for periods ranging from 1-35 months (mean 11 months, median 10 months). At least a further 237 patients (29%) had a period of [ge]50% reduction in seizure frequency. Forty-six patients achieved LEV monotherapy, and 26 of these had periods of seizure freedom ranging from 2-35 months (mean 13 months, median 11 months). Seizure freedom was attained in 120/654 (18%) patients with cryptogenic or symptomatic partial epilepsy and 15/68 (22%) patients with idiopathic generalized epilepsy. Two hundred and sixty nine patients (33%) stopped LEV; discontinuation was due to inefficacy in 110 (14%), adverse events in 81 (10%), both inefficacy and adverse events in 75 (9%) and pregnancy in 3 (0.4%). Nearly two thirds of patients with chronic epilepsy were continuing on LEV therapy at last follow-up. Almost half of patients achieved a period of reduction in seizure frequency of [ge]50%, with nearly one in five achieving a period of seizure freedom. This study, evaluating the largest single-centre cohort of patients taking LEV, confirms the efficacy and tolerability of LEV demonstrated in controlled trials. (Supported by The National Society for Epilepsy, United Kingdom.)