Brivaracetam as add-on treatment in patients with post-stroke epilepsy: real-world data from the BRIVAracetam add-on First Italian netwoRk Study (BRIVAFIRST)
- Authors: Lattanzi S.; Canafoglia L.; Canevini M.P.; Casciato S.; Cerulli Irelli E.; 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.; Alicino A.; Ascoli M.; Assenza G.; Avorio F.; Badioni V.; Banfi P.; Bartolini E.; Basili L.M.; Belcastro V.; Beretta S.; Berto I.; Biggi M.; Billo G.; Boero G.; Bonanni P.; Bongiorno J.; Brigo F.; Caggia E.; Cagnetti C.; Calvello C.; Cesnik E.; Chianale G.; Ciampanelli D.; Ciuffini R.; Cocito D.; Colella D.; Contento M.; Costa C.; Cumbo E.; D'Aniello A.; Deleo F.; DiFrancesco J.C.; Di Giacomo R.; Di Liberto A.; Domina E.; Dono F.; Durante V.; Elia M.; Estraneo A.; Evangelista G.; Faedda M.T.; Failli Y.; Fallica E.; Fattouch J.; Ferrari A.; Ferreri F.; Fisco G.; Fonti D.; Fortunato F.; Foschi N.; Francavilla T.; Galli R.; Gazzina S.; Giallonardo A.T.; Giorgi F.S.; Giuliano L.; Habetswallner F.; Izzi F.; Kassabian B.; Labate A.; Luisi C.; Magliani M.; Maira G.; Mari L.; Marino D.; Mascia A.; Mazzeo A.; Milano C.; Meletti S.; Nilo A.; Orlando B.; Paladin F.; Pascarella M.G.; Pastori C.; Pauletto G.; Peretti A.; Perri G.; Pezzella M.; Piccioli M.; Pignatta P.; Pilolli N.; Pisani F.; Pisani L.R.; Placidi F.; Pollicino P.; Porcella V.; Pradella S.; Puligheddu M.; Quadri S.; Quarato P.P.; Quintas R.; Renna R.; Rizzo G.R.; Rum A.; Salamone E.M.; Savastano E.; Sessa M.; Stokelj D.; Tartara E.; Tombini M.; Tumminelli G.; Vaudano A.E.; Ventura M.; Vigano I.; Viglietta E.; Vignoli A.; Villani F.; Zambrelli E.; Zummo L.
- Publication year: 2022
- Type: Articolo in rivista
- OA Link: http://hdl.handle.net/10447/555863
Abstract
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.