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Multicenter Study
. 2023 Nov;64(11):2922-2933.
doi: 10.1111/epi.17740. Epub 2023 Sep 9.

Adjunctive brivaracetam and sustained seizure frequency reduction in very active focal epilepsy

Simona Lattanzi  1 , Laura Canafoglia  2 , Maria Paola Canevini  3   4 , Sara Casciato  5 , Emanuele Cerulli Irelli  6 , Valentina Chiesa  3 , Filippo Dainese  7 , Giovanni De Maria  8 , Giuseppe Didato  9 , Giancarlo Di Gennaro  5 , Giovanni Falcicchio  10 , Martina Fanella  6 , Edoardo Ferlazzo  11 , Massimo Gangitano  12 , Angela La Neve  10 , Oriano Mecarelli  6 , Elisa Montalenti  13 , Alessandra Morano  6 , Federico Piazza  14 , Chiara Pizzanelli  15   16 , Patrizia Pulitano  6 , Federica Ranzato  17 , Eleonora Rosati  18 , Laura Tassi  19 , Carlo Di Bonaventura  6 ; BRIVAFIRST (Brivaracetam Add‐On First Italian Network Study) Group Membership
Collaborators, Affiliations
Free article
Multicenter Study

Adjunctive brivaracetam and sustained seizure frequency reduction in very active focal epilepsy

Simona Lattanzi et al. Epilepsia. 2023 Nov.
Free article

Abstract

Objective: This study aimed to explore the effectiveness of brivaracetam (BRV) according to baseline seizure frequency and past treatment history in subjects with focal epilepsy who were included in the Brivaracetam Add-On First Italian Network Study (BRIVAFIRST).

Methods: BRIVAFIRST was a 12-month retrospective, multicenter study including adults prescribed adjunctive BRV. Study outcomes included sustained seizure response (SSR), sustained seizure freedom (SSF), and the rates of treatment discontinuation and adverse events (AEs). Baseline seizure frequency was stratified as <5, 5-20, and >20 seizures per month, and the number of prior antiseizure medications (ASMs) as <5 and ≥6.

Results: A total of 994 participants were included. During the 1-year study period, SSR was reached by 45.8%, 39.3%, and 22.6% of subjects with a baseline frequency of <5, 5-20, and >20 seizures per month (p < .001); the corresponding figures for the SSF were 23.4%, 9.8%, and 2.8% (p < .001). SSR was reached by 51.2% and 26.5% participants with a history of 1-5 and ≥6 ASMs (p < .001); the corresponding rates of SSF were 24.7% and 4.5% (p < .001). Treatment discontinuation due to lack of efficacy was more common in participants with >20 seizures compared to those with <5 seizures per month (25.8% vs. 9.3%, p < .001), and in participants with history of ≥6 prior ASMs compared to those with history of 1-5 ASMs (19.6% vs. 12.2%, p = .002). There were no differences in the rates of BRV withdrawal due to AEs and the rates of AEs across the groups of participants defined according to the number of seizures at baseline and the number of prior ASMs.

Significance: The baseline seizure frequency and the number of previous ASMs were predictors of sustained seizure frequency reduction with adjunctive BRV in subjects with focal epilepsy.

Keywords: antiseizure medication; brivaracetam; epilepsy; focal seizures.

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References

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