6533b85efe1ef96bd12c09b6
RESEARCH PRODUCT
Brivaracetam as add-on treatment in patients with post-stroke epilepsy: real-world data from the BRIVAracetam add-on First Italian netwoRk Study (BRIVAFIRST)
Simona LattanziLaura CanafogliaMaria Paola CaneviniSara CasciatoEmanuele Cerulli IrelliValentina ChiesaFilippo DaineseGiovanni De MariaGiuseppe DidatoGiancarlo Di GennaroGiovanni FalcicchioMartina FanellaEdoardo FerlazzoMassimo GangitanoAngela La NeveOriano MecarelliElisa MontalentiAlessandra MoranoFederico PiazzaChiara PizzanelliPatrizia PulitanoFederica RanzatoEleonora RosatiLaura TassiCarlo Di BonaventuraAngela AlicinoMichele AscoliGiovanni AssenzaFederica AvorioValeria BadioniPaola BanfiEmanuele BartoliniLuca Manfredi BasiliVincenzo BelcastroSimone BerettaIrene BertoMartina BiggiGiuseppe BilloGiovanni BoeroPaolo BonanniJole BongornoFrancesco BrigoEmanuele CaggiaClaudia CagnettiCarmen CalvelloEdward CesnikGigliola ChianaleDomenico CiampanelliRoberta CiuffiniDario CocitoDonato ColellaMargerita ContentoCinzia CostaEduardo CumboAlfredo D'anielloFrancesco DeleoJacopo C. DifrancescoRoberta Di GiacomoAlessandra Di LibertoElisabetta DominaFedele DonoVania DuranteMaurizio EliaAnna EstraneoGiacomo EvangelistaMaria Teresa FaeddaYlenia FailliElisa FallicaJinane FattouchAlessandra FerrariFlorinda FerreriGiacomo FiscoDavide FontiFrancesco FortunatoNicoletta FoschiTeresa FrancavillaRosita GalliStefano GazzinaAnna Teresa GiallonardoFilippo Sean GiorgiLoretta GiulianoFrancesco HabetswallnerFrancesca IzziBenedetta KassabianAngelo LabateConcetta LuisiMatteo MaglianiGiulia MairaLuisa MariDaniela MarinoAddolorata MasciaAlessandra MazzeoChiara MilanoStefano MelettiAnnacarmen NiloBiagio OrlandoFrancesco PaladinMaria Grazia PascarellaChiara PastoriGiada PaulettoAlessia PerettiGabriella PerriMarianna PezzellaMarta PiccioliPietro PignattaNicola PilolliFrancesco PisaniLaura Rosa PisaniFabio PlacidiPatrizia PollicinoVittoria PorcellaSilvia PradellaMonica PulighedduStefano QuadriPier Paolo QuaratoRui QuintasRosaria RennaGiada Ricciardo RizzoAdriana RumEnrico Michele SalamoneErsilia SavastanoMaria SessaDavid StokeljElena TartaraMario TombiniGemma TumminelliAnna Elisabetta VaudanoMaria VenturaIlaria ViganòEmanuela VigliettaAglaia VignoliFlavio VillaniElena ZambrelliLeila Zummosubject
AdultAntiseizure medication; Brivaracetam; Cerebrovascular diseases; Focal seizures; StrokeCerebrovascular diseasesSettore MED/26Antiseizure medication Brivaracetam Focal seizures Stroke Cerebrovascular diseasesFocal seizuresDouble-Blind MethodDrug TherapySeizuresHumansAgedRetrospective StudiesAntiseizure medicationEpilepsyGeneral MedicineMiddle AgedPyrrolidinonesStrokeTreatment OutcomeNeurologyItalyCombinationBrivaracetamAntiseizure medication; Brivaracetam; Cerebrovascular diseases; Focal seizures; Stroke; Adult; Aged; Anticonvulsants; Double-Blind Method; Drug Therapy Combination; Humans; Italy; Middle Aged; Pyrrolidinones; Retrospective Studies; Seizures; Treatment Outcome; Epilepsy; StrokeDrug Therapy CombinationAnticonvulsantsNeurology (clinical)description
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 12-month 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 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. 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.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2022-04-01 |