PMID- 38052481
OWN - NLM
STAT- MEDLINE
DCOM- 20240214
LR  - 20240214
IS  - 1528-1167 (Electronic)
IS  - 0013-9580 (Linking)
VI  - 65
IP  - 2
DP  - 2024 Feb
TI  - A real-world comparison among third-generation antiseizure medications: Results 
      from the COMPARE study.
PG  - 456-472
LID - 10.1111/epi.17843 [doi]
AB  - OBJECTIVE: There are few comparative data on the third-generation antiseizure 
      medications (ASMs). We aimed to assess and compare the effectiveness of 
      brivaracetam (BRV), eslicarbazepine acetate (ESL), lacosamide (LCM), and 
      perampanel (PER) in people with epilepsy (PWE). Efficacy and tolerability were 
      compared as secondary objectives. METHODS: This multicenter, retrospective study 
      collected data from 22 Italian neurology/epilepsy centers. All adult PWE who 
      started add-on treatment with one of the studied ASMs between January 2018 and 
      October 2021 were included. Retention rate was established as effectiveness 
      measure and described using Kaplan-Meier curves and the best fitting survival 
      model. The responder status and the occurrence of adverse events (AEs) were used 
      to evaluate efficacy and safety, respectively. The odds of AEs and drug efficacy 
      were estimated by two multilevel logistic models. RESULTS: A total of 960 
      patients (52.92% females, median age = 43 years) met the inclusion criteria. They 
      mainly suffered from structural epilepsy (52.29%) with monthly (46.2%) focal 
      seizures (69.58%). Compared with LCM, all the studied ASMs had a higher dropout 
      risk, statistically significant in the BRV levetiracetam (LEV)-naive (hazard 
      ratio [HR] = 1.97, 95% confidence interval [CI] = 1.17-3.29) and PER groups 
      (HR = 1.64, 95% CI = 1.06-2.55). Women were at higher risk of discontinuing ESL 
      (HR = 5.33, 95% CI = 1.71-16.61), as well as PER-treated patients with unknown 
      epilepsy etiology versus those with structural etiology (HR = 1.74, 95% 
      CI = 1.05-2.88). BRV with prior LEV therapy showed lower odds of efficacy (odds 
      ratio [OR] = .08, 95% CI = .01-.48) versus LCM, whereas a higher efficacy was 
      observed in women treated with BRV and LEV-naive (OR = 10.32, 95% 
      CI = 1.55-68.78) versus men. PER (OR = 6.93, 95% CI = 3.32-14.44) and BRV in 
      LEV-naive patients (OR = 6.80, 95% CI = 2.64-17.52) had a higher chance of AEs 
      than LCM. SIGNIFICANCE: Comparative evidence from real-world studies may help 
      clinicians to tailor treatments according to patients' demographic and clinical 
      characteristics.
CI  - (c) 2023 The Authors. Epilepsia published by Wiley Periodicals LLC on behalf of 
      International League Against Epilepsy.
FAU - Roberti, Roberta
AU  - Roberti R
AD  - Science of Health Department, School of Medicine, Magna Graecia University of 
      Catanzaro, Catanzaro, Italy.
FAU - Di Gennaro, Gianfranco
AU  - Di Gennaro G
AD  - Science of Health Department, School of Medicine, Magna Graecia University of 
      Catanzaro, Catanzaro, Italy.
FAU - Anzellotti, Francesca
AU  - Anzellotti F
AUID- ORCID: 0000-0003-0808-3042
AD  - Department of Neurology, Epilepsy Center, SS Annunziata Hospital, Chieti, Italy.
FAU - Arnaldi, Dario
AU  - Arnaldi D
AD  - Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and 
      Child Health, Clinical Neurology, University of Genoa, Genoa, Italy.
AD  - IRCSS Ospedale Policlinico San Martino, Genoa, Italy.
FAU - Belcastro, Vincenzo
AU  - Belcastro V
AD  - Neurology Unit, Maggiore Hospital, ASST Lodi, Lodi, Italy.
FAU - Beretta, Simone
AU  - Beretta S
AD  - Department of Neurology, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy.
FAU - Boero, Giovanni
AU  - Boero G
AD  - Complex Structure of Neurology, SS Annunziata Hospital, Taranto, Italy.
FAU - Bonanni, Paolo
AU  - Bonanni P
AD  - Epilepsy and Clinical Neurophysiology Unit, Scientific Institute, IRCCS Eugenio 
      Medea, Conegliano, Treviso, Italy.
FAU - Canafoglia, Laura
AU  - Canafoglia L
AUID- ORCID: 0000-0002-5385-761X
AD  - Integrated Diagnostics for Epilepsy, Fondazione IRCCS Istituto Neurologico Besta, 
      Milan, Italy.
FAU - D'Aniello, Alfredo
AU  - D'Aniello A
AD  - IRCCS Neuromed, Pozzilli, Italy.
FAU - Dainese, Filippo
AU  - Dainese F
AD  - Clinical Neurophysiology Unit, Clinical Neurology, DIDAS Department, Padua, 
      Italy.
FAU - De Caro, Carmen
AU  - De Caro C
AD  - Science of Health Department, School of Medicine, Magna Graecia University of 
      Catanzaro, Catanzaro, Italy.
FAU - Di Gennaro, Giancarlo
AU  - Di Gennaro G
AD  - IRCCS Neuromed, Pozzilli, Italy.
FAU - Di Giacomo, Roberta
AU  - Di Giacomo R
AUID- ORCID: 0000-0003-4202-955X
AD  - Epilepsy Unit, Fondazione IRCCS Istituto Neurologico Besta, Milan, Italy.
FAU - DiFrancesco, Jacopo C
AU  - DiFrancesco JC
AUID- ORCID: 0000-0002-4102-1188
AD  - Department of Neurology, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy.
FAU - Dono, Fedele
AU  - Dono F
AUID- ORCID: 0000-0003-3575-2942
AD  - Department of Neurology, Epilepsy Center, SS Annunziata Hospital, Chieti, Italy.
AD  - Department of Neuroscience, Imaging and Clinical Science, D'Annunzio University 
      of Chieti-Pescara, Chieti, Italy.
FAU - Falcicchio, Giovanni
AU  - Falcicchio G
AUID- ORCID: 0000-0003-0745-5246
AD  - DiBraiN Department, University of Bari Aldo Moro, Bari, Italy.
FAU - Ferlazzo, Edoardo
AU  - Ferlazzo E
AD  - Department of Medical and Surgical Sciences, Magna Graecia University of 
      Catanzaro, Catanzaro, Italy.
AD  - Regional Epilepsy Center, Bianchi-Melacrino-Morelli Great Metropolitan Hospital, 
      Reggio Calabria, Italy.
FAU - Foschi, Nicoletta
AU  - Foschi N
AD  - Neurological Clinic, Department of Experimental and Clinical Medicine, Marche 
      Polytechnic University, Ancona, Italy.
FAU - Franciotta, Silvia
AU  - Franciotta S
AD  - Clinical Neurophysiology Unit, Clinical Neurology, DIDAS Department, Padua, 
      Italy.
FAU - Gambardella, Antonio
AU  - Gambardella A
AUID- ORCID: 0000-0001-7384-3074
AD  - Department of Medical and Surgical Sciences, Institute of Neurology, Magna 
      Graecia University of Catanzaro, Catanzaro, Italy.
FAU - Giordano, Alfonso
AU  - Giordano A
AD  - Department of Advanced Medical and Surgical Sciences, University of Campania 
      Luigi Vanvitelli, Naples, Italy.
FAU - Iannone, Luigi Francesco
AU  - Iannone LF
AD  - Section of Clinical Pharmacology and Oncology, Department of Health Sciences, 
      University of Florence, Florence, Italy.
FAU - Labate, Angelo
AU  - Labate A
AUID- ORCID: 0000-0002-8827-7324
AD  - Neurophysiopathology and Movement Disorders Clinic, University of Messina, 
      Messina, Italy.
FAU - La Neve, Angela
AU  - La Neve A
AD  - DiBraiN Department, University of Bari Aldo Moro, Bari, Italy.
FAU - Lattanzi, Simona
AU  - Lattanzi S
AUID- ORCID: 0000-0001-8748-0083
AD  - Neurological Clinic, Department of Experimental and Clinical Medicine, Marche 
      Polytechnic University, Ancona, Italy.
FAU - Leggio, Ugo
AU  - Leggio U
AD  - Unit of Neurophysiopathology, ASST Spedali Civili, Brescia, Italy.
FAU - Liguori, Claudio
AU  - Liguori C
AUID- ORCID: 0000-0003-2845-1332
AD  - Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
AD  - Neurology Unit, Epilepsy Center, University Hospital Tor Vergata, Rome, Italy.
FAU - Maschio, Marta
AU  - Maschio M
AD  - Center for Tumor-Related Epilepsy, UOSD Neuro-Oncology, IRCCS Regina Elena 
      National Cancer Institute, Rome, Italy.
FAU - Nilo, Annacarmen
AU  - Nilo A
AUID- ORCID: 0000-0001-9827-8059
AD  - Clinical Neurology Unit, Department of Head, Neck, and Neurosciences, Santa Maria 
      della Misericordia University Hospital, Udine, Italy.
FAU - Operto, Francesca Felicia
AU  - Operto FF
AUID- ORCID: 0000-0002-2444-8761
AD  - Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery, and 
      Dentistry, University of Salerno, Fisciano, Italy.
FAU - Pascarella, Angelo
AU  - Pascarella A
AUID- ORCID: 0000-0002-0085-9494
AD  - Department of Medical and Surgical Sciences, Magna Graecia University of 
      Catanzaro, Catanzaro, Italy.
AD  - Regional Epilepsy Center, Bianchi-Melacrino-Morelli Great Metropolitan Hospital, 
      Reggio Calabria, Italy.
FAU - Pauletto, Giada
AU  - Pauletto G
AD  - Neurology Unit, Department of Head, Neck, and Neurosciences, Santa Maria della 
      Misericordia University Hospital, Udine, Italy.
FAU - Renna, Rosaria
AU  - Renna R
AD  - Neurology and Stroke Unit, Department of Emergency and Acceptance, AORN Antonio 
      Cardarelli Hospital, Naples, Italy.
FAU - Strigaro, Gionata
AU  - Strigaro G
AD  - Neurology Unit, Department of Translational Medicine, Epilepsy Center, University 
      of Piemonte Orientale, Novara, Italy.
AD  - Maggiore della Carita University Hospital, Novara, Italy.
CN  - COMPARE Study Group
FAU - Russo, Emilio
AU  - Russo E
AUID- ORCID: 0000-0002-1279-8123
AD  - Science of Health Department, School of Medicine, Magna Graecia University of 
      Catanzaro, Catanzaro, Italy.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20231216
PL  - United States
TA  - Epilepsia
JT  - Epilepsia
JID - 2983306R
RN  - 0 (Anticonvulsants)
RN  - 44YRR34555 (Levetiracetam)
RN  - 563KS2PQY5 (Lacosamide)
RN  - 0 (Pyrrolidinones)
RN  - H821664NPK (perampanel)
RN  - 0 (Nitriles)
RN  - 0 (Pyridones)
SB  - IM
MH  - Male
MH  - Adult
MH  - Humans
MH  - Female
MH  - Anticonvulsants/adverse effects
MH  - *Epilepsies, Partial/drug therapy
MH  - Retrospective Studies
MH  - Levetiracetam/therapeutic use
MH  - Lacosamide/therapeutic use
MH  - *Epilepsy/drug therapy
MH  - Pyrrolidinones/therapeutic use
MH  - Treatment Outcome
MH  - *Nitriles
MH  - *Pyridones
OTO - NOTNLM
OT  - brivaracetam
OT  - comparative study
OT  - eslicarbazepine acetate
OT  - lacosamide
OT  - perampanel
EDAT- 2023/12/06 03:43
MHDA- 2024/02/14 12:46
CRDT- 2023/12/05 20:43
PHST- 2023/11/22 00:00 [revised]
PHST- 2023/07/31 00:00 [received]
PHST- 2023/11/30 00:00 [accepted]
PHST- 2024/02/14 12:46 [medline]
PHST- 2023/12/06 03:43 [pubmed]
PHST- 2023/12/05 20:43 [entrez]
AID - 10.1111/epi.17843 [doi]
PST - ppublish
SO  - Epilepsia. 2024 Feb;65(2):456-472. doi: 10.1111/epi.17843. Epub 2023 Dec 16.