Real Life Experience of Brivaracetam in Focal to Bilateral and Primary Generalized Tonic-Clonic Seizures
Abstract number :
1.297
Submission category :
7. Anti-seizure Medications / 7C. Cohort Studies
Year :
2021
Submission ID :
1826327
Source :
www.aesnet.org
Presentation date :
12/4/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:53 AM
Authors :
Ariadna Gifreu Fraixinó, MD - Epilepsy Unit, Neurology department. Vall d’Hebron Hospital. Barcelona; Laura Abraira – Epilepsy Unit, Neurology department. Vall d’Hebron Hospital. Barcelona; Elena Fonseca – Epilepsy Unit, Neurology department. Vall d’Hebron Hospital. Barcelona; Manuel Quintana – Epilepsy Unit, Neurology department. Vall d’Hebron Hospital. Barcelona; Juan Rodríguez Uranga – Centro de Neurología Avanzada. Sevilla; Estevo Santamarina – Epilepsy Unit, Neurology department. Vall d’Hebron Hospital. Barcelona; Manuel Toledo – Epilepsy Unit, Neurology department. Vall d’Hebron Hospital. Barcelona; Javier Abril Jaramillo – Centro de Neurología Avanzada. Sevilla
Rationale: Brivaracetam (BRV) is an antiseizure medication (ASM) indicated for focal onset seizures. It has shown efficacy in focal to bilateral tonic-clonic seizures (FBTCS). However, its efficacy in primary generalized tonic-clonic seizures (GTCS) is unknown. The aim of this study is to determine real life efficacy and safety of BRV in patients with FBTCS and GTCS.
Methods: We performed a multicenter retrospective longitudinal study including patients over 16 years that had at least one FBTCS or GTCS within the last 3 months prior to the start of BRV.
Data was collected from the consecutive outpatient visits during a period of 3 years. All patients needed a certain diagnostic of epilepsy and a minimum follow-up of 3 months prior to starting BRV (baseline visit) and 6 months after (final visit). Incomplete medical records or lost to follow-up before 6 months were excluded.
Efficacy was based on the FBTCS or GTCS frequency during the 3 months before baseline compared to the 3 months prior to the final visit. Other seizure types were not considered for the efficacy analysis. Adverse events (AE) were collected as they occurred during follow-up.
Results: We recruited 46 patients, 54.3% women, with a mean age of 30.8 years (SD 14.9). FBTCS were 34.8% and GTCS 65.2%. At final visit, patients reduced seizure frequency from a mean of 3.7 to 2.1 (p < 0.001). A reduction of > 50% seizure frequency was shown in 74.4% and 58.1% of patients achieved seizure freedom. Retention rate was 83.7% at 6 months.
Factors associated to seizure freedom were FBTCS (85.7% vs 44.8%, p = 0.011), non-drug resistance (86.7% vs 42.9%, p = 0.006), lower number of previous ASMs (2 vs 4.5, p = 0.006) and lower concomitant ASMs (1 vs 2.5, p = 0.007).
Conclusions: BRV is an effective and well-tolerated ASM in FBTCS and also in GTCS. Even in the presence of drug-resistant epilepsy, nearly half of patients do not have FBTCS or GTCS in the medium term follow-up.
Funding: Please list any funding that was received in support of this abstract.: No funding.
Anti-seizure Medications