Brivaracetam in the treatment of focal and idiopathic generalized epilepsies and of status epilepticus. Issue 5 (3rd May 2016)

• Record Type: Journal Article
• Authors: Strzelczyk, Adam; Klein, Karl Martin; Willems, Laurent M.; Rosenow, Felix; Bauer, Sebastian
• Is Part Of: Expert review of clinical pharmacology. Volume 9:Issue 5(2016)
• Page Start: 637
• Page End: 645
• Publication Date: 2016-05-03
• Subjects: Brivaracetam -- epilepsy -- myoclonus -- seizure; Clinical pharmacology -- Periodicals; 615.105
• DOI: 10.1586/17512433.2016.1156529
• Languages: English
• ISSNs: 1751-2433

Abstract

ABSTRACT: Brivaracetam is the latest approved antiepileptic drug in focal epilepsy and exhibits high affinity as SV2A-ligand. More than two thousand patients have received brivaracetam within randomized placebo-controlled trials. Significant median seizure reduction rates of 30.5% to 53.1% for 50 mg/d, 32.5% to 37.2% for 100 mg/d and 35.6% for 200 mg/d were reported. Likewise, 50% responder rates were 32.7% to 55.8% for 50 mg/d, 36% to 38.9% for 100 mg/d and 37.8% for 200 mg/d. Overall, brivaracetam is well tolerated. The main adverse events are fatigue, dizziness, and somnolence. Immediate switch from levetiracetam to brivaracetam at a conversion ratio between 10:1 to 15:1 is feasible, and might alleviate the behavioral side effects associated with levetiracetam. Brivaracetam has the potential to perform as an important, possibly broad-spectrum AED, initially in patients with drug-refractory epilepsies. Its intravenous formulation may be a new and desirable alternative for status epilepticus, but there is so far no experience in these patients.