Brivaracetam as add-on treatment in patients with post-stroke epilepsy: real-world data from the BRIVAracetam add-on First Italian netwoRk Study (BRIVAFIRST). (April 2022)

• Record Type: Journal Article
• Authors: Lattanzi, Simona; Canafoglia, Laura; Canevini, Maria Paola; Casciato, Sara; Irelli, Emanuele Cerulli; Chiesa, Valentina; Dainese, Filippo; De Maria, Giovanni; Didato, Giuseppe; Gennaro, Giancarlo Di; Falcicchio, Giovanni; Fanella, Martina; Ferlazzo, Edoardo; Gangitano, Massimo; La Neve, Angela; Mecarelli, Oriano; Montalenti, Elisa; Morano, Alessandra; Piazza, Federico; Pizzanelli, Chiara; Pulitano, Patrizia; Ranzato, Federica; Rosati, Eleonora; Tassi, Laura; Di Bonaventura, Carlo; Alicino, Angela; Ascoli, Michele; Assenza, Giovanni; Avorio, Federica; Badioni, Valeria; Banfi, Paola; Bartolini, Emanuele; Basili, Luca Manfredi; Belcastro, Vincenzo; Beretta, Simone; Berto, Irene; Biggi, Martina; Billo, Giuseppe; Boero, Giovanni; Bonanni, Paolo; Bongorno, Jole; Brigo, Francesco; Caggia, Emanuele; Cagnetti, Claudia; Calvello, Carmen; Cesnik, Edward; Chianale, Gigliola; Ciampanelli, Domenico; Ciuffini, Roberta; Cocito, Dario; Colella, Donato; Contento, Margerita; Costa, Cinzia; Cumbo, Eduardo; D'Aniello, Alfredo; Deleo, Francesco; DiFrancesco, Jacopo C; Di Giacomo, Roberta; Di Liberto, Alessandra; Domina, Elisabetta; Dono, Fedele; Durante, Vania; Elia, Maurizio; Estraneo, Anna; Evangelista, Giacomo; Faedda, Maria Teresa; Failli, Ylenia; Fallica, Elisa; Fattouch, Jinane; Ferrari, Alessandra; Ferreri, Florinda; Fisco, Giacomo; Fonti, Davide; Fortunato, Francesco; Foschi, Nicoletta; Francavilla, Teresa; Galli, Rosita; Gazzina, Stefano; Giallonardo, Anna Teresa; Giorgi, Filippo Sean; Giuliano, Loretta; Habetswallner, Francesco; Izzi, Francesca; Kassabian, Benedetta; Labate, Angelo; Luisi, Concetta; Magliani, Matteo; Maira, Giulia; Mari, Luisa; Marino, Daniela; Mascia, Addolorata; Mazzeo, Alessandra; Milano, Chiara; Meletti, Stefano; Nilo, Annacarmen; Orlando, Biagio; Paladin, Francesco; Pascarella, Maria Grazia; Pastori, Chiara; Pauletto, Giada; Peretti, Alessia; Perri, Gabriella; Pezzella, Marianna; Piccioli, Marta; Pignatta, Pietro; Pilolli, Nicola; Pisani, Francesco; Pisani, Laura Rosa; Placidi, Fabio; Pollicino, Patrizia; Porcella, Vittoria; Pradella, Silvia; Puligheddu, Monica; Quadri, Stefano; Quarato, Pier Paolo; Quintas, Rui; Renna, Rosaria; Rizzo, Giada Ricciardo; Rum, Adriana; Salamone, Enrico Michele; Savastano, Ersilia; Sessa, Maria; Stokelj, David; Tartara, Elena; Tombini, Mario; Tumminelli, Gemma; Vaudano, Anna Elisabetta; Ventura, Maria; Viganò, Ilaria; Viglietta, Emanuela; Vignoli, Aglaia; Villani, Flavio; Zambrelli, Elena; Zummo, Lelia;
• Is Part Of: Seizure. Volume 97(2022)
• Page Start: 37
• Page End: 42
• Publication Date: 2022-04
• Subjects: Antiseizure medication -- Brivaracetam -- Focal seizures -- Stroke -- Cerebrovascular diseases; Epilepsy -- Periodicals; Epilepsy -- Periodicals; Seizures -- Periodicals; Épilepsie -- Périodiques; Electronic journals; Electronic journals; 616.853
• DOI: 10.1016/j.seizure.2022.03.007
• Languages: English
• ISSNs: 1059-1311

Abstract

Highlights: Adjunctive brivaracetam (BRV) improved seizure frequency in patients with post-stroke epilepsy (PSE) The median daily dose of BRV at 12 months was 100 mg Adjunctive BRV was generally well-tolerated in patients with PSE in clinical practice Most adverse events were rated as mild in intensity Brivaracetam can be a suitable add-on therapeutic option for patients with PSE Abstract: Objective: Post-stroke epilepsy (PSE) is one of the most common causes of acquired epilepsy and accounts for about 10-15% of all newly diagnosed epilepsy cases. However, evidence about the clinical profile of antiseizure medications in the PSE setting is currently limited. Brivaracetam (BRV) is a rationally developed compound characterized by high-affinity binding to synaptic vesicle protein 2A. The aim of this study was to assess the 12-month effectiveness and tolerability of adjunctive BRV in patients with PSE treated in a real-world setting. Methods: This was a subgroup analysis of patients with PSE included in the BRIVAracetam add-on First Italian netwoRk Study (BRIVAFIRST). The BRIVAFIRST was a 12-month retrospective, multicentre study including adult patients prescribed adjunctive BRV. Effectiveness outcomes included the rates of seizure response (≥50% reduction in baseline seizure frequency), seizure‐freedom, and treatment discontinuation. Safety and tolerability outcomes included the rate of treatment discontinuation due to adverse events (AEs) and the incidence of AEs. Results: Patients with PSE included in the BRIVAFIRST were 75 and had a median age of 57 (interquartile range, 42-66) years. The median daily doses of BRV at 3, 6, and 12 months from starting treatment were 100 (100-150) mg, 125 (100-200) mg and 100 (100-200) mg, respectively. At 12 months, 32 (42.7%) patients had a reduction in their baseline seizure frequency by at least 50%, and the seizure freedom rates was 26/75 (34.7%). During the 1-year study period, 10 (13.3%) patients discontinued BRV. The reasons of treatment withdrawal were insufficient efficacy in 6 (8.0%) patients and poor tolerability in 4 (5.3%) patients. Adverse events were reported by 13 (20.3%) patients and were rated as mild in 84.6% and moderate in 15.4% of cases. Significance: Adjunctive BRV was efficacious and generally well-tolerated when used in patients with PSE in clinical practice. Adjunctive BRV can be a suitable therapeutic option for patients with PSE.