Brivaracetam in the treatment of focal and idiopathic generalized epilepsies and of status epilepticus

Expert Review of Clinical Pharmacology
Adam StrzelczykSebastian Bauer

Abstract

Brivaracetam is the latest approved antiepileptic drug in focal epilepsy and exhibits high affinity as SV2A-ligand. More than two thousand patients have received brivaracetam within randomized placebo-controlled trials. Significant median seizure reduction rates of 30.5% to 53.1% for 50 mg/d, 32.5% to 37.2% for 100 mg/d and 35.6% for 200 mg/d were reported. Likewise, 50% responder rates were 32.7% to 55.8% for 50 mg/d, 36% to 38.9% for 100 mg/d and 37.8% for 200 mg/d. Overall, brivaracetam is well tolerated. The main adverse events are fatigue, dizziness, and somnolence. Immediate switch from levetiracetam to brivaracetam at a conversion ratio between 10:1 to 15:1 is feasible, and might alleviate the behavioral side effects associated with levetiracetam. Brivaracetam has the potential to perform as an important, possibly broad-spectrum AED, initially in patients with drug-refractory epilepsies. Its intravenous formulation may be a new and desirable alternative for status epilepticus, but there is so far no experience in these patients.

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Citations

Jun 9, 2016·Expert Opinion on Pharmacotherapy·Alexandra RohracherEugen Trinka
Jul 9, 2016·Der Nervenarzt·A StrzelczykS Bauer
Jul 25, 2017·Expert Opinion on Pharmacotherapy·Jasmina R MilovanovićMarina Kostić
Jun 29, 2018·Epilepsia·Heidrun Potschka, Eugen Trinka
Aug 20, 2020·Expert Opinion on Pharmacotherapy·Adam StrzelczykSebastian Bauer
Dec 30, 2017·Expert Review of Clinical Pharmacology·Laurent M WillemsAdam Strzelczyk
Jan 29, 2019·Frontiers in Neurology·Adam StrzelczykFelix von Podewils
Feb 23, 2018·Frontiers in Neurology·Felix ZahnertSusanne Knake
Nov 16, 2019·Epilepsy & Behavior : E&B·Elena FonsecaManuel Toledo
Feb 10, 2021·Seizure : the Journal of the British Epilepsy Association·Niccolò OrlandiTiziano Zanoni
Mar 23, 2021·Der Nervenarzt·F RosenowUNKNOWN Österreichische Gesellschaft für Neurologie (ÖGN)
Apr 6, 2018·Journal of Medicinal Chemistry·Andrew C FlickChristopher J O'Donnell

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