Brivaracetam as add-on treatment in patients with post-stroke epilepsy: real-world data from the BRIVAracetam add-on First Italian netwoRk Study (BRIVAFIRST).

Adult Aged Anticonvulsants / therapeutic use Double-Blind Method Drug Therapy, Combination Epilepsy / chemically induced Humans Italy Middle Aged Pyrrolidinones / therapeutic use Retrospective Studies Seizures / drug therapy Stroke / complications Treatment Outcome

Antiseizure medication Brivaracetam Cerebrovascular diseases Focal seizures Stroke

Journal

Seizure

ISSN: 1532-2688

Titre abrégé: Seizure

Pays: England

ID NLM: 9306979

Informations de publication

Date de publication:
Apr 2022

Historique:

received: 13 02 2022

revised: 06 03 2022

accepted: 09 03 2022

pubmed: 24 3 2022

medline: 4 5 2022

entrez: 23 3 2022

Statut: ppublish

Résumé

Post-stroke epilepsy (PSE) is one of the most common causes of acquired epilepsy and accounts for about 10-15% of all newly diagnosed epilepsy cases. However, evidence about the clinical profile of antiseizure medications in the PSE setting is currently limited. Brivaracetam (BRV) is a rationally developed compound characterized by high-affinity binding to synaptic vesicle protein 2A. The aim of this study was to assess the 12-month effectiveness and tolerability of adjunctive BRV in patients with PSE treated in a real-world setting. This was a subgroup analysis of patients with PSE included in the BRIVAracetam add-on First Italian netwoRk Study (BRIVAFIRST). The BRIVAFIRST was a 12-month retrospective, multicentre study including adult patients prescribed adjunctive BRV. Effectiveness outcomes included the rates of seizure response (≥50% reduction in baseline seizure frequency), seizure-freedom, and treatment discontinuation. Safety and tolerability outcomes included the rate of treatment discontinuation due to adverse events (AEs) and the incidence of AEs. Patients with PSE included in the BRIVAFIRST were 75 and had a median age of 57 (interquartile range, 42-66) years. The median daily doses of BRV at 3, 6, and 12 months from starting treatment were 100 (100-150) mg, 125 (100-200) mg and 100 (100-200) mg, respectively. At 12 months, 32 (42.7%) patients had a reduction in their baseline seizure frequency by at least 50%, and the seizure freedom rates was 26/75 (34.7%). During the 1-year study period, 10 (13.3%) patients discontinued BRV. The reasons of treatment withdrawal were insufficient efficacy in 6 (8.0%) patients and poor tolerability in 4 (5.3%) patients. Adverse events were reported by 13 (20.3%) patients and were rated as mild in 84.6% and moderate in 15.4% of cases. Adjunctive BRV was efficacious and generally well-tolerated when used in patients with PSE in clinical practice. Adjunctive BRV can be a suitable therapeutic option for patients with PSE.

Identifiants

DOI: 10.1016/j.seizure.2022.03.007 PMID: 35320736

pubmed: 35320736

pii: S1059-1311(22)00055-3

doi: 10.1016/j.seizure.2022.03.007

pii:

doi:

Substances chimiques

Anticonvulsants 0

Pyrrolidinones 0

brivaracetam U863JGG2IA

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

Pagination

37-42

Investigateurs

Angela Alicino (A)

Michele Ascoli (M)

Giovanni Assenza (G)

Federica Avorio (F)

Valeria Badioni (V)

Paola Banfi (P)

Emanuele Bartolini (E)

Luca Manfredi Basili (LM)

Vincenzo Belcastro (V)

Simone Beretta (S)

Irene Berto (I)

Martina Biggi (M)

Giuseppe Billo (G)

Giovanni Boero (G)

Paolo Bonanni (P)

Jole Bongorno (J)

Francesco Brigo (F)

Emanuele Caggia (E)

Claudia Cagnetti (C)

Carmen Calvello (C)

Edward Cesnik (E)

Gigliola Chianale (G)

Domenico Ciampanelli (D)

Roberta Ciuffini (R)

Dario Cocito (D)

Donato Colella (D)

Margerita Contento (M)

Cinzia Costa (C)

Eduardo Cumbo (E)

Alfredo D'Aniello (A)

Francesco Deleo (F)

Jacopo C DiFrancesco (JC)

Roberta Di Giacomo (R)

Alessandra Di Liberto (A)

Elisabetta Domina (E)

Fedele Dono (F)

Vania Durante (V)

Maurizio Elia (M)

Anna Estraneo (A)

Giacomo Evangelista (G)

Maria Teresa Faedda (MT)

Ylenia Failli (Y)

Elisa Fallica (E)

Jinane Fattouch (J)

Alessandra Ferrari (A)

Florinda Ferreri (F)

Giacomo Fisco (G)

Davide Fonti (D)

Francesco Fortunato (F)

Nicoletta Foschi (N)

Teresa Francavilla (T)

Rosita Galli (R)

Stefano Gazzina (S)

Anna Teresa Giallonardo (AT)

Filippo Sean Giorgi (FS)

Loretta Giuliano (L)

Francesco Habetswallner (F)

Francesca Izzi (F)

Benedetta Kassabian (B)

Angelo Labate (A)

Concetta Luisi (C)

Matteo Magliani (M)

Giulia Maira (G)

Luisa Mari (L)

Daniela Marino (D)

Addolorata Mascia (A)

Alessandra Mazzeo (A)

Chiara Milano (C)

Stefano Meletti (S)

Annacarmen Nilo (A)

Biagio Orlando (B)

Francesco Paladin (F)

Maria Grazia Pascarella (MG)

Chiara Pastori (C)

Giada Pauletto (G)

Alessia Peretti (A)

Gabriella Perri (G)

Marianna Pezzella (M)

Marta Piccioli (M)

Pietro Pignatta (P)

Nicola Pilolli (N)

Francesco Pisani (F)

Laura Rosa Pisani (LR)

Fabio Placidi (F)

Patrizia Pollicino (P)

Vittoria Porcella (V)

Silvia Pradella (S)

Monica Puligheddu (M)

Stefano Quadri (S)

Pier Paolo Quarato (PP)

Rui Quintas (R)

Rosaria Renna (R)

Giada Ricciardo Rizzo (GR)

Adriana Rum (A)

Enrico Michele Salamone (EM)

Ersilia Savastano (E)

Maria Sessa (M)

David Stokelj (D)

Elena Tartara (E)

Mario Tombini (M)

Gemma Tumminelli (G)

Anna Elisabetta Vaudano (AE)

Maria Ventura (M)

Ilaria Viganò (I)

Emanuela Viglietta (E)

Aglaia Vignoli (A)

Flavio Villani (F)

Elena Zambrelli (E)

Lelia Zummo (L)