Treatment with brivaracetam in children - The experience of a pediatric epilepsy center.
Epilepsy Behav
; 101(Pt A): 106541, 2019 12.
Article
em En
| MEDLINE
| ID: mdl-31698260
ABSTRACT
INTRODUCTION:
The new anticonvulsant brivaracetam is a levetiracetam analog which binds to the synaptic vesicle protein 2A, and inhibits excitatory neurotransmitters' release. Brivaracetam was Food and Drug Administration (FDA) and European Medicine Agency (EMA) approved in 2016 as adjunctive treatment for focal onset seizures in patients over 16â¯years of age, and in 2018 for children over four years of age. Our aim was to describe effectiveness and tolerability in real-life pediatric epilepsy clinic.METHODS:
Cross-sectional retrospective chart review of patients under 20â¯years of age, treated with brivaracetam. Positive response to treatment was considered when 50% decrease in seizure frequency was noted. In responders to levetiracetam, positive effect was regarded if switching to brivaracetam maintained at least the same seizure control.RESULTS:
Thirty-one patients (67.7% males), aged 13.8⯱â¯4.07 (6.9-20â¯years), were treated with brivaracetam 3.8â¯mg/kg⯱â¯1.8. Age of onset of epilepsy was 5.7⯱â¯3.7â¯years; 20 patients had focal epilepsies; and 11 had epileptic syndromes (5 - Lennox-Gastaut, 3 - myoclonic absence, 3 - myoclonic-atonic). Responder rate was 45.2%, with no statistical difference under and over 16â¯years of age (40% vs. 54.5%, Fisher's exact test). Eight patients had better response to seizures compared to levetiracetam. Gender, duration of epilepsy, and dosage did not affect epilepsy control. Six patients had seizure aggravation. Adverse effects were rare mild somnolence (6.4%), psychosis (3.2%), and nausea (3.2%).CONCLUSION:
Brivaracetam is an effective add-on treatment in focal, as well as generalized seizures in children, with negligible side effects, including children who failed previously on levetiracetam. Seizure exacerbation may occur, but it's reason is unclear.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pirrolidinonas
/
Epilepsia
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Síndromes Epilépticas
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Anticonvulsivantes
Tipo de estudo:
Observational_studies
/
Prevalence_studies
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Risk_factors_studies
Limite:
Adolescent
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Adult
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Child
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Female
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Humans
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Male
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article