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. 2023 Nov:148:109464.
doi: 10.1016/j.yebeh.2023.109464. Epub 2023 Oct 13.

The real-world effectiveness of intravenous brivaracetam as a second-line treatment in status epilepticus

Chiara Martellino  1 , Angelina Laganà  2 , Giorgia Atanasio  1 , Fabio Lamanna  1 , Silvia Attardo  1 , Simona Cascino  1 , Marcella De Luca  1 , Orazio Pardeo  1 , Giuseppa Giacobbe  1 , Giovanni Tripepi  3 , Roberta Roberti  4 , Francesca Granata  5 , Carmela Morace  6 , Emilio Russo  4 , Angelo Labate  7
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The real-world effectiveness of intravenous brivaracetam as a second-line treatment in status epilepticus

Chiara Martellino et al. Epilepsy Behav. 2023 Nov.

Abstract

Purpose: Status epilepticus (SE) is defined by abnormally prolonged seizures that may lead to brain damage and death. Our aim was to evaluate the efficacy and tolerability (effectiveness) of intravenous brivaracetam (BRV) as a second-line treatment.

Methods: Twenty-one patients (median age 68 years ± 17.28) were prospectively recruited between June 2019 and December 2022. Patients were treated with BRV (50-200 mg) as a second-line add-on therapy for SE. We evaluated the response of SE to the administration of BRV in terms of SE termination and recurrence of epileptic seizures at 6, 12, and 24 h, also monitoring safety. The first-line therapy was represented by intravenous benzodiazepines (mainly diazepam).

Results: Almost a quarter of patients had generalized seizures, whereas the vast majority (76.2%) presented focal seizures. In 52.4% of patients, the underlying cause was cerebrovascular. Fourteen (66.7%) patients displayed a good early response in the subsequent 6 h. At 12 and 24 h, 8 (38%) and 11 (52.4%) patients, respectively, did not present seizures.

Conclusion: The present study highlights the potential of BRV when used as an early add-on therapy in SE, further confirming its good safety profile.

Keywords: Brivaracetam; Early add-on; Efficacy; Safety; Second line; Treatment.

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Conflict of interest statement

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: E.R. has received speaker fees or funding from and has participated in advisory boards for Angelini Pharma, Eisai, Pfizer, GW Pharmaceuticals, Jazz Pharmaceuticals, UCB, and Kolfarma; AL has received consulting fees or speaker honoraria from UCB Pharma, Eisai, GW Pharmaceuticals, Bial, and Lusopharma. All other authors have no conflict of interest to disclose.

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