PMID- 38300459 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240322 IS - 2193-8253 (Print) IS - 2193-6536 (Electronic) IS - 2193-6536 (Linking) VI - 13 IP - 2 DP - 2024 Apr TI - Conversion to Brivaracetam Monotherapy in Clinical Practice: A Retrospective Study. PG - 389-398 LID - 10.1007/s40120-024-00580-2 [doi] AB - INTRODUCTION: The study aimed to evaluate the effectiveness and safety of brivaracetam (BRV) as conversion monotherapy in adults with focal epilepsy treated in the context of real-world clinical practice. METHODS: This was a retrospective, observational, non-interventional study in adults with focal epilepsy who converted to BRV monotherapy following the withdrawal of background antiseizure medications (ASMs). Primary effectiveness outcome was the retention rate of BRV as single ASM at 6 and 12 months. Secondary outcomes included the 6- and 12-month rates of seizure freedom. Safety and tolerability outcomes included the frequency and type of adverse events (AEs) and the occurrence of treatment discontinuation due to AEs. RESULTS: A total of 44 participants with a median age of 63.5 (interquartile range 44-73.5) years were included; 17 subjects were seizure free at baseline, and 9 of them switched from levetiracetam because of lack of tolerability. The retention rate of BRV monotherapy was 88.6% (39/44) at 6 months and 83.9% (26/31) at 12 months. The rates of seizure freedom were 72.7% (32/44) in subjects with 6-month follow-up and 58.1% (18/31) in subjects with 12-month follow-up. The median maintenance dosage of BRV monotherapy was 150 (100-200) mg/day at 6 months and 125 (100-200) mg/day in subjects with 12-month follow-up. Adverse events were recorded in 6/44 (13.6%) participants and led to BRV discontinuation in 2/44 (4.5%) cases. The reported AEs were somnolence (n = 3), fatigue (n = 2), and irritability (n = 1); no serious AEs were experienced. In 21/44 (47.7%) participants, BRV monotherapy resulted from the direct switch from levetiracetam. The rates of treatment retention and seizure freedom at 6 and 12 months were higher among people who switched from levetiracetam to BRV monotherapy. CONCLUSION: Brivaracetam may be a valuable treatment of focal seizures in people who converted to monotherapy in a real-life setting. CI - (c) 2024. The Author(s). FAU - Lattanzi, Simona AU - Lattanzi S AUID- ORCID: 0000-0001-8748-0083 AD - Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Via Conca 71, 60020, Ancona, Italy. alfierelattanzisimona@gmail.com. FAU - Foschi, Nicoletta AU - Foschi N AD - Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Via Conca 71, 60020, Ancona, Italy. FAU - Martellino, Chiara AU - Martellino C AD - Neurophysiopathology and Movement Disorders Clinic, University of Messina, Messina, Italy. FAU - Audenino, Daniela AU - Audenino D AD - S.C. Neurologia, S.S.C. Neurofisiopatologia, E.O. Ospedali Galliera, Genoa, Italy. FAU - Boero, Giovanni AU - Boero G AD - Division 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 - Ferlazzo, Edoardo AU - Ferlazzo E AD - Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy. FAU - Chiesa, Valentina AU - Chiesa V AD - Epilepsy Center, Child Neuropsychiatry Unit, AAST Santi Paolo Carlo, Milan, Italy. FAU - Dainese, Filippo AU - Dainese F AD - Unit of Neurology and Unit of Clinical Neurophysiology, Department of Neuroscience, University of Padua, Padua, Italy. FAU - Piccioli, Marta AU - Piccioli M AD - Neurology Unit, PO San Filippo Neri, ASL Roma 1, Rome, Italy. FAU - Ferrari, Alessandra AU - Ferrari A AD - Division of Clinical Neurophysiology and Epilepsy Centre, Department of Neuroscience, IRCCS Ospedale Policlinico San Martino, Genoa, Italy. FAU - Labate, Angelo AU - Labate A AD - Neurophysiopathology and Movement Disorders Clinic, University of Messina, Messina, Italy. LA - eng PT - Journal Article DEP - 20240201 PL - New Zealand TA - Neurol Ther JT - Neurology and therapy JID - 101637818 PMC - PMC10951135 OTO - NOTNLM OT - Antiseizure medication OT - Brivaracetam OT - Epilepsy OT - Focal seizures COIS- Simona Lattanzi has received speaker's or consultancy fees from Angelini Pharma, Eisai, GW Pharmaceuticals, Medscape, and UCB Pharma and has served on advisory boards for Angelini Pharma, Arvelle Therapeutics, BIAL, Eisai, GW Pharmaceuticals, and Rapport Therapeutics outside the submitted work. Daniela Audenino has received speaker or consultancy fees from Angelini Pharma and UCB Pharma outside the submitted work. Paolo Bonanni has received speaker's or consultancy fees from EISAI, Angelini, Jazz and Livanova and has served on advisory boards for BIAL, Eisai, Proveca outside the submitted work. Filippo Dainese has received speaker or consultancy fees from Angelini Pharma, Eisai and UCB Pharma outside the submitted work. Valentina Chiesa has received speaker and advisory board honoraria from Angelini Pharma, Eisai Pharma, GW, UCB Pharma outside the submitted work. Filippo Dainese has received speaker or consultancy fees from Angelini Pharma, Eisai and UCB Pharma outside the submitted work. Marta Piccioli has received speaker's or consultancy fees from Angelini, EISAI, and UCB Pharma outside the submitted work. Nicoletta Foschi, Chiara Martellino, Giovanni Boero, Edoardo Ferlazzo, Alessandra Ferrari, and Angelo Labate have no conflicts of interest to declare. EDAT- 2024/02/01 12:42 MHDA- 2024/02/01 12:43 PMCR- 2024/02/01 CRDT- 2024/02/01 11:17 PHST- 2023/11/27 00:00 [received] PHST- 2024/01/09 00:00 [accepted] PHST- 2024/02/01 12:43 [medline] PHST- 2024/02/01 12:42 [pubmed] PHST- 2024/02/01 11:17 [entrez] PHST- 2024/02/01 00:00 [pmc-release] AID - 10.1007/s40120-024-00580-2 [pii] AID - 580 [pii] AID - 10.1007/s40120-024-00580-2 [doi] PST - ppublish SO - Neurol Ther. 2024 Apr;13(2):389-398. doi: 10.1007/s40120-024-00580-2. Epub 2024 Feb 1.