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Adjunctive brivaracetam and sustained seizure frequency reduction in very active focal epilepsy.
Lattanzi, Simona; Canafoglia, Laura; Canevini, Maria Paola; Casciato, Sara; Cerulli Irelli, Emanuele; Chiesa, Valentina; Dainese, Filippo; De Maria, Giovanni; Didato, Giuseppe; Di Gennaro, Giancarlo; 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.
Afiliación
  • Lattanzi S; Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy.
  • Canafoglia L; Department of Epileptology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
  • Canevini MP; Epilepsy Center, Child Neuropsychiatry Unit, AAST Santi Paolo Carlo, Milan, Italy.
  • Casciato S; Department of Health Sciences, Università degli Studi, Milan, Italy.
  • Cerulli Irelli E; IRCCS Neuromed, Pozzilli, Italy.
  • Chiesa V; Department of Human Neurosciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
  • Dainese F; Epilepsy Center, Child Neuropsychiatry Unit, AAST Santi Paolo Carlo, Milan, Italy.
  • De Maria G; Epilepsy Center, Neurology Unit, Venice, Italy.
  • Didato G; Clinical Neurophysiology Unit, Epilepsy Center, Spedali Civili, Brescia, Italy.
  • Di Gennaro G; Epilepsy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
  • Falcicchio G; IRCCS Neuromed, Pozzilli, Italy.
  • Fanella M; Department of Basic Medical Sciences, Neurosciences and Sense Organs, University Hospital of Bari A. Moro, Bari, Italy.
  • Ferlazzo E; Department of Human Neurosciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
  • Gangitano M; Department of Medical and Surgical Sciences, Magna Græcia University of Catanzaro, Catanzaro, Italy.
  • La Neve A; Department of Biomedicine, Neuroscience, and Advanced Diagnostics, University of Palermo, Palermo, Italy.
  • Mecarelli O; Department of Basic Medical Sciences, Neurosciences and Sense Organs, University Hospital of Bari A. Moro, Bari, Italy.
  • Montalenti E; Department of Human Neurosciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
  • Morano A; Epilepsy Center, AOU Città della Salute e della Scienza di Torino, Turin, Italy.
  • Piazza F; Department of Human Neurosciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
  • Pizzanelli C; Rita Levi Montalcini Department of Neurosciences, University of Turin, Turin, Italy.
  • Pulitano P; Department of Translational Research on New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
  • Ranzato F; Neurology Unit, Pisa University Hospital, Pisa, Italy.
  • Rosati E; Department of Human Neurosciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
  • Tassi L; Epilepsy Center, UOC Neurology, AULSS 8 Vicenza, Vicenza, Italy.
  • Di Bonaventura C; Department of Neurofarba, University of Florence, Florence, Italy.
Epilepsia ; 64(11): 2922-2933, 2023 Nov.
Article en En | MEDLINE | ID: mdl-38079181
ABSTRACT

OBJECTIVE:

This study aimed to explore the effectiveness of brivaracetam (BRV) according to baseline seizure frequency and past treatment history in subjects with focal epilepsy who were included in the Brivaracetam Add-On First Italian Network Study (BRIVAFIRST).

METHODS:

BRIVAFIRST was a 12-month retrospective, multicenter study including adults prescribed adjunctive BRV. Study outcomes included sustained seizure response (SSR), sustained seizure freedom (SSF), and the rates of treatment discontinuation and adverse events (AEs). Baseline seizure frequency was stratified as <5, 5-20, and >20 seizures per month, and the number of prior antiseizure medications (ASMs) as <5 and ≥6.

RESULTS:

A total of 994 participants were included. During the 1-year study period, SSR was reached by 45.8%, 39.3%, and 22.6% of subjects with a baseline frequency of <5, 5-20, and >20 seizures per month (p < .001); the corresponding figures for the SSF were 23.4%, 9.8%, and 2.8% (p < .001). SSR was reached by 51.2% and 26.5% participants with a history of 1-5 and ≥6 ASMs (p < .001); the corresponding rates of SSF were 24.7% and 4.5% (p < .001). Treatment discontinuation due to lack of efficacy was more common in participants with >20 seizures compared to those with <5 seizures per month (25.8% vs. 9.3%, p < .001), and in participants with history of ≥6 prior ASMs compared to those with history of 1-5 ASMs (19.6% vs. 12.2%, p = .002). There were no differences in the rates of BRV withdrawal due to AEs and the rates of AEs across the groups of participants defined according to the number of seizures at baseline and the number of prior ASMs.

SIGNIFICANCE:

The baseline seizure frequency and the number of previous ASMs were predictors of sustained seizure frequency reduction with adjunctive BRV in subjects with focal epilepsy.
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Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Epilepsias Parciales / Anticonvulsivantes Límite: Adult / Humans Idioma: En Revista: Epilepsia Año: 2023 Tipo del documento: Article País de afiliación: Italia

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Epilepsias Parciales / Anticonvulsivantes Límite: Adult / Humans Idioma: En Revista: Epilepsia Año: 2023 Tipo del documento: Article País de afiliación: Italia