Sustained seizure freedom with adjunctive brivaracetam in patients with focal onset seizures

Epilepsia. 2022 May;63(5):e42-e50. doi: 10.1111/epi.17223. Epub 2022 Mar 26.

Abstract

The maintenance of seizure control over time is a clinical priority in patients with epilepsy. The aim of this study was to assess the sustained seizure frequency reduction with adjunctive brivaracetam (BRV) in real-world practice. Patients with focal epilepsy prescribed add-on BRV were identified. Study outcomes included sustained seizure freedom and sustained seizure response, defined as a 100% and a ≥50% reduction in baseline seizure frequency that continued without interruption and without BRV withdrawal through the 12-month follow-up. Nine hundred ninety-four patients with a median age of 45 (interquartile range = 32-56) years were included. During the 1-year study period, sustained seizure freedom was achieved by 142 (14.3%) patients, of whom 72 (50.7%) were seizure-free from Day 1 of BRV treatment. Sustained seizure freedom was maintained for ≥6, ≥9, and 12 months by 14.3%, 11.9%, and 7.2% of patients from the study cohort. Sustained seizure response was reached by 383 (38.5%) patients; 236 of 383 (61.6%) achieved sustained ≥50% reduction in seizure frequency by Day 1, 94 of 383 (24.5%) by Month 4, and 53 of 383 (13.8%) by Month 7 up to Month 12. Adjunctive BRV was associated with sustained seizure frequency reduction from the first day of treatment in a subset of patients with uncontrolled focal epilepsy.

Keywords: antiseizure medication; brivaracetam; focal seizures; seizure freedom; sodium channel blockers.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anticonvulsants* / therapeutic use
  • Double-Blind Method
  • Drug Therapy, Combination
  • Epilepsies, Partial* / drug therapy
  • Freedom
  • Humans
  • Middle Aged
  • Pyrrolidinones / therapeutic use
  • Seizures / drug therapy
  • Treatment Outcome

Substances

  • Anticonvulsants
  • Pyrrolidinones
  • brivaracetam