Rapid Intravenous Loading of Brivaracetam During Invasive and Non-invasive Video-eeg Monitoring
Abstract number :
1.306
Submission category :
7. Anti-seizure Medications / 7E. Other
Year :
2022
Submission ID :
2203928
Source :
www.aesnet.org
Presentation date :
12/3/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:22 AM
Authors :
Beatriz Chavarría Cano, MD – Hospital del Mar; Riccardo Zucca, PhD – Hospital del Mar; Alessandro Principe, Md,PhD – Hospital del Mar; Abel sanabria, MD – Hospital del Mar; Rodrigo Rocamora, Md, PhD – Hospital del Mar
Rationale: Brivaracetam (BRV) pharmacokinetics and its fast penetration across the blood‐brain barrier make this drug amenable for emergency use._x000D_
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We aimed to explore the tolerability, safety, and efficacy of BRV rapid intravenous (IV) loading during invasive and non‐invasive video-EEG monitoring in patients with drug-resistant focal epilepsy (DRFE).
Methods: Eleven adults, six in stereoelectroencephalographic (SEEG) and five in scalp video-EEG monitoring (Table1), received 10 min IV-infusion of BRV 100 mg after a period of total antiseizure medications (ASMs) withdrawal. To evaluate acute efficacy, we defined a 5-hours baseline period before the IV BRV administration and a 5-hours treatment period after the loading.The primary efficacy outcome was defined as the number of seizures during the treatment period compared with the baseline period. The secondary efficacy outcome was the changes in the interictal epileptiform discharges (IEDs). Tolerability and adverse events were assessed through the Liverpool Adverse Events Profile (LAEP) scale. Spectrographic analysis of the EEG activity was also performed.
Results: Rapid BRV IV infusion was well tolerated. Mean LAEP values showed non‐significant differences (p=0.23). Loading BRV resulted in interictal activity reduction in six patients (Figure 1B).The mean frequency of seizures was significantly reduced from baseline to the treatment period (4.14 ± 3.9 vs. 0.85 ± 1.8 seizures, p= 0.027), (Figure 1A). Across the whole group, a total reduction of 79.2% of seizures was observed. Ten minutes after BRV, a significant change in spectral band‐analysis was observed.
Conclusions: Our data suggest that a rapid BRV IV-infusion has a safety profile. Also, it was effective in controlling seizures in the short term, being useful in clinical situations with increased seizure activity. Electrophysiological changes were observed after the BRV‐load as a correlation of its effects on brain dynamics.
Funding: Beatriz Chavarría and Rodrigo Rocamora have received travel support and speaker honoraria from UCB. The other authors have no competing interests to report. Riccardo Zucca is supported by the Emergent Cluster of the Human Brain and the European Regional Development Fund (FEDER, 001-P-001682).
Anti-seizure Medications