Sustained seizure freedom with adjunctive brivaracetam in patients with focal onset seizures.

Simona Lattanzi, Simona Lattanzi, Michele Ascoli, Michele Ascoli, Laura Canafoglia, Laura Canafoglia, Maria Paola Canevini, Maria Paola Canevini, Sara Casciato, Sara Casciato, Emanuele Cerulli Irelli, Emanuele Cerulli Irelli, Valentina Chiesa, Valentina Chiesa, Filippo Dainese, Filippo Dainese, Giovanni De Maria, Giovanni De Maria, Giuseppe Didato, Giuseppe Didato, Giancarlo Di Gennaro, Giancarlo Di Gennaro, Giovanni Falcicchio, Giovanni Falcicchio, Martina Fanella, Martina Fanella, Massimo Gangitano, Massimo Gangitano, Angela La Neve, Angela La Neve, Oriano Mecarelli, Oriano Mecarelli, Elisa Montalenti, Elisa Montalenti, Alessandra Morano, Alessandra Morano, Federico Piazza, Federico Piazza, Chiara Pizzanelli, Chiara Pizzanelli, Patrizia Pulitano, Patrizia Pulitano, Federica Ranzato, Federica Ranzato, Eleonora Rosati, Eleonora Rosati, Laura Tassi, Laura Tassi, Carlo Di Bonaventura, Carlo Di Bonaventura

Journal: Epilepsia 2022;63(5):e42-e50

PMID: 35278335

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Abstract

The maintenance of seizure control over time is a clinical priority in patients with epilepsy. The aim of this study was to assess the sustained seizure frequency reduction with adjunctive brivaracetam (BRV) in real-world practice. Patients with focal epilepsy prescribed add-on BRV were identified. Study outcomes included sustained seizure freedom and sustained seizure response, defined as a 100% and a ≥50% reduction in baseline seizure frequency that continued without interruption and without BRV withdrawal through the 12-month follow-up. Nine hundred ninety-four patients with a median age of 45 (interquartile range = 32-56) years were included. During the 1-year study period, sustained seizure freedom was achieved by 142 (14.3%) patients, of whom 72 (50.7%) were seizure-free from Day 1 of BRV treatment. Sustained seizure freedom was maintained for ≥6, ≥9, and 12 months by 14.3%, 11.9%, and 7.2% of patients from the study cohort. Sustained seizure response was reached by 383 (38.5%) patients; 236 of 383 (61.6%) achieved sustained ≥50% reduction in seizure frequency by Day 1, 94 of 383 (24.5%) by Month 4, and 53 of 383 (13.8%) by Month 7 up to Month 12. Adjunctive BRV was associated with sustained seizure frequency reduction from the first day of treatment in a subset of patients with uncontrolled focal epilepsy.

Address: Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy.; Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy.; Department of Epileptology, Carlo Besta Neurological Institute, Scientific Institute for Research and Health Care Foundation, Milan, Italy.; Epilepsy Center, Child Neuropsychiatry Unit, AAST Santi Paolo Carlo, Milan, Italy.; Department of Health Sciences, University of Studies, Milan, Italy.; Neuromed, Scientific Institute for Research and Health Care, Pozzilli, Italy.; Department of Human Neurosciences, Umberto I Polyclinic, Sapienza University of Rome, Rome, Italy.; Epilepsy Center, Child Neuropsychiatry Unit, AAST Santi Paolo Carlo, Milan, Italy.; Epilepsy Center, Neurology Unit, Venice, Italy.; Clinical Neurophysiology Unit, Epilepsy Center, Civil Hospitals, Brescia, Italy.; Epilepsy Unit, Carlo Besta Neurological Institute, Scientific Institute for Research and Health Care Foundation, Milan, Italy.; Department of Basic Medical Sciences, Neurosciences and Sense Organs, A. Moro University Hospital of Bari, Bari, Italy.; Department of Biomedicine, Neuroscience, and Advanced Diagnostics, University of Palermo, Palermo, Italy.; Epilepsy Center, City AOU of Health and Science of Turin, Turin, Italy.; Rita Levi Montalcini Department of Neurosciences, University of Turin, Turin, Italy.; Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy.; Epilepsy Center, UOC Neurology, AULSS 8 Vicenza, Vicenza, Italy.; Department of Neurology 2, Careggi University Hospital, Florence, Italy.; C. Munari Epilepsy Surgery Center, Niguarda Hospital, Milan, Italy.

DOI: 10.1111/epi.17223

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MeSH Terms: Adult, Anticonvulsants, Double-Blind Method, Drug Therapy, Combination, Epilepsies, Partial, Freedom, Humans, Middle Aged, Pyrrolidinones, Seizures, Treatment Outcome