Brivaracetam use in children with epilepsy: A retrospective multicenter study

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Authors	ŠPILÁROVÁ Zuzana SLÁDKOVÁ Sára BELOHLAVKOVA A. ČESKÁ Katarína HANÁKOVÁ Petra HOŘÁK Ondřej JAHODOVA A. KNEDLÍKOVÁ Lenka KOLÁŘ Senad EBEL M. KUDR M. OŠLEJŠKOVÁ Hana RYZÍ Michal ŠPANĚLOVÁ Klára STERBOVA K. KOUBOVÁ Anna KRSEK P. DANHOFER Pavlína
Year of publication	2024
Type	Article in Periodical
Magazine / Source	Seizure-European journal of epilepsy
MU Faculty or unit	Faculty of Medicine
Citation
Web	https://www.sciencedirect.com/science/article/pii/S1059131124002462?via%3Dihub
Doi	http://dx.doi.org/10.1016/j.seizure.2024.08.022
Keywords	Brivaracetam; Pediatric epilepsy; Response rate; Retention rate; Overnight switch; Side effects
Description	Purpose: This retrospective multicenter study aimed to assess the efficacy and safety of brivaracetam (BRV) in pediatric epilepsy. Methods: Our cohort consisted of 93 children (mean age 11.5 +/- 7.5 years) with a wide spectrum of pediatric epilepsy, including epileptic encephalopathy and generalized epilepsy. Of these, 61 (60.4%) were diagnosed with focal epilepsy, 19 (15.8%) with generalized epilepsy, and 16 (15.8%) with combined epilepsy, while 8 patients (7.9%) had an unknown epilepsy type. The cohort included rare epilepsy syndromes: 8 patients with LennoxGastaut syndrome, 3 with Dravet syndrome, and 1 with Rasmussen syndrome. Patients had a history of various antiseizure medications (ASMs) (6.42 +/- 3.15), and on average, were being treated with more than two (2.57 +/- 1.16) drugs at the time of BRV deployment. Results: Retention rates were high, with 80.6% of patients adhering to treatment at 3 months, 66.7% at 6 months, and 45.2% at 12 months. In 29 patients (30.1%), BRV was added in an overnight switch from levetiracetam (LEV), resulting in a reduction of behavioral adverse effects (AEs) in 5 patients (17.2%). The response rate was 25.8% at 3 months, 16.1% at 6 months, and 17.2% at 12 months, with no responders in the epileptic encephalopathy group. Therapy tolerance was notable, with 70 patients (75.3%) reporting no AEs. Transient AEs occurred in 10 patients (10.7%), and in 13 cases (14.0%), the AEs warranted dose adjustment or discontinuation of BRV. Conclusion: Approximately one-fifth of pediatric patients with drug-resistant epilepsy responded to BRV, with the best response observed in patients with focal seizures. However, the impact on patients with epileptic encephalopathy was limited.