Adjunctive Brivaracetam in People with Epilepsy and Intellectual Disability: Evidence from the BRIVAracetam Add-On First Italian netwoRk Study
- Authors: Lattanzi S.; Canafoglia L.; Canevini M.P.; Casciato S.; Irelli E.C.; Chiesa V.; Dainese F.; De Maria G.; Didato G.; Di Gennaro G.; Falcicchio G.; Fanella M.; Ferlazzo E.; Gangitano M.; La Neve A.; Mecarelli O.; Montalenti E.; Morano A.; Piazza F.; Pizzanelli C.; Pulitano P.; Ranzato F.; Rosati E.; Tassi L.; Di Bonaventura C.; Zumm L.; Zambrelli E.; Villani F.; Vignoli A.; Viglietta E.; Vigano I.; Ventura M.; Vaudano A.E.; Tumminelli G.; Tombini M.; Tartara E.; Stokelj D.; Sessa M.; Savastano E.; Salamone E.M.; Rum A.; Rizzo G.R.; Renna R.; Quintas R.; Quarato P.P.; Quadri S.; Puligheddu M.; Pradella S.; Porcella V.; Pollicino P.; Placidi F.; Pisani L.R.; Pisani F.; Pilolli N.; Pignatta P.; Piccioli M.; Pezzella M.; Perri G.; Peretti A.; Pauletto G.; Pastori C.; Pascarella M.G.; Paladin F.; Orlando B.; Nilo A.; Milano C.; Meletti S.; Mazzeo A.; Mascia A.; Marino D.; Mari L.; Maira G.; Magliani M.; Luisi C.; Labate A.; Kassabian B.; Izzi F.; Habetswallner F.; Giuliano L.; Giorgi F.S.; Giallonardo A.T.; Gazzina S.; Galli R.; Francavilla T.; Foschi N.; Fortunato F.; Fonti D.; Fisco G.; Ferreri F.; Ferrari A.; Fattouch J.; Fallica E.; Failli Y.; Faedda M.T.; Evangelista G.; Estraneo A.; Elia M.; Durante V.; Dono F.; Domina E.; Liberto A.R.D.; Giacomo R.D.; DiFrancesco J.C.; Deleo F.; D'Aniello A.; Cumbo E.; Costa C.; Contento M.; Colella D.; Cocito D.; Ciuffini R.; Ciampanelli D.; Chianale G.; Cesnik E.; Calvello C.; Cagnetti C.; Caggia E.; Brigo F.; Bongiorno J.; Bonanni P.; Boero G.; Billo G.; Biggi M.; Berto I.; Beretta S.; Belcastro V.; Basili L.M.; Bartolini E.; Banfi P.; Badioni V.; Avorio F.; Assenza G.; Ascoli M.; Alicino A.
- Publication year: 2025
- Type: Articolo in rivista
- OA Link: http://hdl.handle.net/10447/683705
Abstract
Introduction: Subjects with intellectual disability are usually excluded from clinical trials and there is limited evidence-based guidance for the choice of antiseizure medications in this vulnerable population. The study explored the effectiveness of brivaracetam (BRV) in people with epilepsy and intellectual disability. Methods: BRIVAracetam add-on First Italian netwoRk Study (BRIVAFIRST) was a 12-month retrospective, multicenter study including adults prescribed adjunctive BRV. Main outcomes included the rates of seizure‐freedom, seizure response (≥ 50% reduction in baseline seizure frequency), and treatment discontinuation. The occurrence of adverse events (AEs) was also considered. Analyses by the presence and severity of intellectual disability were performed. Results: Subjects with intellectual disability were 253 (24.6%) out of 1029 participants. The 12-month rates of seizure freedom were 18.4% and 10.3% in participants without and with intellectual disability, respectively; the corresponding values for seizure response were 40.0% and 28.9%. Intellectual disability was not an independent predictor of seizure outcomes. The rates of treatment discontinuation were 25.8% and 26.4% in participants without and with intellectual disability. respectively. There were no statistically significant differences in the rates of any AEs, somnolence, nervousness/agitation, and aggressiveness by the presence and degree of intellectual disability. Conclusion: Brivaracetam can be a suitable treatment option and offer opportunities for clinical improvement in subjects with intellectual disability and uncontrolled seizures.