PMID- 31731108
OWN - NLM
STAT- MEDLINE
DCOM- 20201109
LR  - 20201109
IS  - 1525-5069 (Electronic)
IS  - 1525-5050 (Linking)
VI  - 102
DP  - 2020 Jan
TI  - Efficacy, retention, and safety of brivaracetam in adult patients with genetic 
      generalized epilepsy.
PG  - 106657
LID - S1525-5050(19)30842-X [pii]
LID - 10.1016/j.yebeh.2019.106657 [doi]
AB  - OBJECTIVE: The aim of this study was to evaluate the efficacy, tolerability, and 
      retention of brivaracetam (BRV) in genetic generalized epilepsy (GGE) in 
      real-life practice. METHODS: This is a retrospective cohort study of adult 
      patients with GGE in whom BRV was started between 2016 and 2018, completing a 
      follow-up period of >/=6 months. Clinical and electroencephalogram (EEG) 
      characteristics were analyzed at baseline and at follow-up as outcome measures. 
      RESULTS: Brivaracetam was started in 37 patients (mean age: 29.9 +/- 12.3 years; 
      73% women). Juvenile myoclonic epilepsy was the most common syndrome (43.2%). The 
      primary indications for starting BRV were lack of efficacy (51.4%) and adverse 
      events (AEs) (27%) of other antiepileptic drugs (AEDs). In total, 32.4% of 
      patients received BRV monotherapy. Retention rate at 6 months was 81.1%; 83.8% of 
      patients were considered responders, and 62.2% achieved seizure freedom. The 
      primary reasons for withdrawal were treatment-emergent adverse events (TEAEs, 
      57.1%) and lack of efficacy (42.9%). The higher number of prior AED use was a 
      risk factor for a lack of response [median = 4 (interquartile range (IQR): 3-4) 
      vs 2 (IQR: 1-3); p < 0.05]. Patients with a previous response to valproic acid 
      tended to have a higher response rate to BRV (86.7% vs 50%, p = 0.169). 
      Eighty-three point eight percent (83.8%) of previous levetiracetam (LEV) 
      responders also showed a good response to BRV. In terms of patients who presented 
      LEV-related AEs, AE resolution was observed in 79.8%, particularly with regard to 
      psychiatric AEs. Follow-up EEGs were compared with baseline EEGs in 25 patients 
      (67.6%) during follow-up. Most patients showed a reduction (52%) or no change 
      (36%) in interictal epileptiform discharge (IED) frequency. SIGNIFICANCE: 
      Brivaracetam shows good responder and retention rates in GGE and is generally 
      well tolerated. It is an appropriate alternative treatment for GGE, especially in 
      refractory epilepsy and when other AEDs are not tolerated.
CI  - Copyright (c) 2019 Elsevier Inc. All rights reserved.
FAU - Fonseca, Elena
AU  - Fonseca E
AD  - Epilepsy Unit, Neurology Department, Hospital Vall d'Hebron, Department of 
      Medicine, Universitat Autonoma de Barcelona, Pg. Vall d'Hebron, 119-129, 08035 
      Barcelona, Spain. Electronic address: e.fonseca@vhebron.net.
FAU - Guzman, Lorena
AU  - Guzman L
AD  - Neurophysiology Department, Hospital Vall d'Hebron, Department of Medicine, 
      Universitat Autonoma de Barcelona, Pg. Vall d'Hebron, 119-129, 08035 Barcelona, 
      Spain.
FAU - Quintana, Manuel
AU  - Quintana M
AD  - Epilepsy Unit, Neurology Department, Hospital Vall d'Hebron, Department of 
      Medicine, Universitat Autonoma de Barcelona, Pg. Vall d'Hebron, 119-129, 08035 
      Barcelona, Spain. Electronic address: maquintana@vhebron.net.
FAU - Abraira, Laura
AU  - Abraira L
AD  - Epilepsy Unit, Neurology Department, Hospital Vall d'Hebron, Department of 
      Medicine, Universitat Autonoma de Barcelona, Pg. Vall d'Hebron, 119-129, 08035 
      Barcelona, Spain. Electronic address: labraira@vhebron.net.
FAU - Santamarina, Estevo
AU  - Santamarina E
AD  - Epilepsy Unit, Neurology Department, Hospital Vall d'Hebron, Department of 
      Medicine, Universitat Autonoma de Barcelona, Pg. Vall d'Hebron, 119-129, 08035 
      Barcelona, Spain. Electronic address: esantama@vhebron.net.
FAU - Salas-Puig, Xavier
AU  - Salas-Puig X
AD  - Epilepsy Unit, Neurology Department, Hospital Vall d'Hebron, Department of 
      Medicine, Universitat Autonoma de Barcelona, Pg. Vall d'Hebron, 119-129, 08035 
      Barcelona, Spain.
FAU - Toledo, Manuel
AU  - Toledo M
AD  - Epilepsy Unit, Neurology Department, Hospital Vall d'Hebron, Department of 
      Medicine, Universitat Autonoma de Barcelona, Pg. Vall d'Hebron, 119-129, 08035 
      Barcelona, Spain. Electronic address: mtoledo@vhebron.net.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20191112
PL  - United States
TA  - Epilepsy Behav
JT  - Epilepsy & behavior : E&B
JID - 100892858
RN  - 0 (Anticonvulsants)
RN  - 0 (Pyrrolidinones)
RN  - U863JGG2IA (brivaracetam)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Anticonvulsants/adverse effects/*therapeutic use
MH  - Electroencephalography/drug effects/methods
MH  - Epilepsy, Generalized/*drug therapy/*genetics/psychology
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - *Medication Adherence/psychology
MH  - Middle Aged
MH  - Pyrrolidinones/adverse effects/*therapeutic use
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - Young Adult
OTO - NOTNLM
OT  - Brivaracetam
OT  - Genetic generalized epilepsy
OT  - Refractory
OT  - SV2A
OT  - Seizure
EDAT- 2019/11/16 06:00
MHDA- 2020/11/11 06:00
CRDT- 2019/11/16 06:00
PHST- 2019/08/26 00:00 [received]
PHST- 2019/10/18 00:00 [revised]
PHST- 2019/10/19 00:00 [accepted]
PHST- 2019/11/16 06:00 [pubmed]
PHST- 2020/11/11 06:00 [medline]
PHST- 2019/11/16 06:00 [entrez]
AID - S1525-5050(19)30842-X [pii]
AID - 10.1016/j.yebeh.2019.106657 [doi]
PST - ppublish
SO  - Epilepsy Behav. 2020 Jan;102:106657. doi: 10.1016/j.yebeh.2019.106657. Epub 2019 
      Nov 12.