Seizure Frequency Reduced With Long-Term Adjunctive Brivaracetam

Analysis supports sustained efficacy of brivaracetam 50 to 200mg/day
Analysis supports sustained efficacy of brivaracetam 50 to 200mg/day

VANCOUVER, BC—Long-term adjunctive brivaracetam treatment reduces seizure frequency and sustains seizure freedom, data from a pooled analysis presented at the 68th Annual AAN Meeting have shown.

Brivaracetam is approved as adjunctive therapy for partial-onset (focal) seizures in adults 16 years of age and older with epilepsy. To evaluate its long-term efficacy in open-label use, Manuel Toledo, MD, PhD, of the Department of Neurology, Hospital Vall d'Hebron, Barcelona, Spain, and colleagues pooled data from 6 Phase 2/3 studies and 3 follow-up studies.

A total of 1,904 patients received brivaracetam 5–200mg/day in fixed or flexible doses and 1 or 2 concomitant antiepileptic drugs, most commonly carbamazepine, lamotrigine, valproate, oxcarbazepine, topiramate, levetiracetam, or phenytoin. Concomitant levetiracetam was limited to 20% of patients in two of the studies and was not permitted in one of the studies.

Mean age at baseline was 36.8 years; 51.0% of the patients were male and 70.3% were white.

At the time of the analysis, 22 patients had received brivaracetam for ≥8 years, 1500 (79%) for ≥6 months, 1188 (62%) for 12 months, 847 (44%) for 24 months, and 553 (29%) for 60 months.  

Results showed that "overall, there was a median reduction in partial-onset seizure frequency of 48.8% from baseline," Dr. Toledo reported. By cohort, this reduction was 49.4% in the 6-month group, 56.5% in the 12-month group, 61.1% in the 24-month group, and 65.2% in the 60-month group.

The overall ≥50% responder rate was 48.9%; by cohort, this was 49.3% in the 6-month group, 56.4% in the 12-month group, 63.2% in the 24-month group, and 66.4% in the 60-month group. The percentage of patients continuously seizure-free for the duration of treatment with brivaracetam was 5.3%, 4.6%, 3.7%, and 3.6% in the 6-, 12-, 24-, and 60-month cohorts, respectively.

Health-related quality of life scores also improved for all patients receiving brivaracetam, as measured by the Quality of Life in Epilepsy Inventory-31P test, "with seizure worry showing the most meaningful improvement," Dr. Toledo concluded.

Dr. Toledo received personal compensation from UCB Pharma, BIAL, and Eisai, and received research support from Eisai.