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

被引：10

作者：

Lattanzi, Simona ^{[1
]}

Canafoglia, Laura ^{[2
]}

Canevini, Maria Paola ^{[3
,4
]}

Casciato, Sara ^{[5
]}

Irelli, Emanuele Cerulli ^{[6
]}

Chiesa, Valentina ^{[3
]}

Dainese, Filippo ^{[7
]}

De Maria, Giovanni ^{[8
]}

Didato, Giuseppe ^{[9
]}

Di Gennaro, Giancarlo ^{[5
]}

Falcicchio, Giovanni ^{[10
]}

Fanella, Martina ^{[6
]}

Ferlazzo, Edoardo ^{[11
]}

Gangitano, Massimo ^{[12
]}

La Neve, Angela ^{[10
]}

Mecarelli, Oriano ^{[6
]}

Montalenti, Elisa ^{[13
]}

Morano, Alessandra ^{[6
]}

Piazza, Federico ^{[14
]}

Pizzanelli, Chiara ^{[15
,16
]}

Pulitano, Patrizia ^{[6
]}

Ranzato, Federica ^{[17
]}

Rosati, Eleonora ^{[18
]}

Tassi, Laura ^{[19
]}

Di Bonaventura, Carlo ^{[6
]}

机构：

[1] Marche Polytech Univ, Dept Expt & Clin Med, Neurol Clin, Via Conca 71, I-60020 Ancona, Italy

[2] Fdn IRCCS Ist Neurol Carlo Besta, Dept Epileptol, Milan, Italy

[3] AAST Santi Paolo Carlo, Epilepsy Ctr, Child Neuropsychiat Unit, Milan, Italy

[4] Univ Milan, Dept Hlth Sci, Milan, Italy

[5] IRCCS Neuromed, Pozzilli, Italy

[6] Sapienza Univ Rome, Dept Human Neurosci, Policlin Umberto I, Rome, Italy

[7] Epilepsy Ctr, Neurol Unit, Venice, Italy

[8] Spedali Civil Brescia, Epilepsy Ctr, Clin Neurophysiol Unit, Brescia, Italy

[9] Fdn IRCCS Ist Neurol Carlo Besta, Epilepsy Unit, Milan, Italy

[10] Univ Hosp Bari A Moro, Dept Basic Med Sci Neurosci & Sense Organs, Bari, Italy

[11] Magna Graecia Univ Catanzaro, Dept Med & Surg Sci, Catanzaro, Italy

[12] Univ Palermo, Dept Biomed Neurosci & Adv Diagnost BIND, Palermo, Italy

[13] AOU Citta Salute & Sci Torino, Epilepsy Ctr, Turin, Italy

[14] Univ Turin, Rita Levi Montalcini Dept Neurosci, Turin, Italy

[15] Univ Pisa, Dept Translat Res New Technol Med & Surg, Pisa, Italy

[16] Pisa Univ Hosp, Neurol Unit, Pisa, Italy

[17] AULSS 8 Vicenza, Epilepsy Ctr, UOC Neurol, Vicenza, Italy

[18] Careggi Univ Hosp, Dept Neurol 2, Florence, Italy

[19] Osped Niguarda Ca Granda, C Munari Epilepsy Surg Ctr, Milan, Italy

来源：

SEIZURE-EUROPEAN JOURNAL OF EPILEPSY | 2022年 / 97卷

关键词：

Antiseizure medication; Brivaracetam; Focal seizures; Stroke; Cerebrovascular diseases; SEIZURES; CARBAMAZEPINE; MONOTHERAPY;

D O I：

10.1016/j.seizure.2022.03.007

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Objective: 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 12month effectiveness and tolerability of adjunctive BRV in patients with PSE treated in a real-world setting. Methods: 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. Results: 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 1year 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. Significance: 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.

引用

页码：37 / 42

页数：6

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