First clinical postmarketing experiences in the treatment of epilepsies with brivaracetam: a retrospective observational multicentre study

Objectives Brivaracetam (BRV) is the latest approved antiepileptic drug and acts as a synaptic vesicle protein 2A ligand. The aim of the present study was to evaluate the efficacy and tolerability of BRV in the clinical setting.Design Retrospective, observational multicentre study.Setting We retrosp...

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Main Authors: Katja Menzler, Peter Michael Mross, Felix Rosenow, Susanne Schubert-Bast, Laurent Maximilian Willems, Felix Zahnert, Ilka Immisch, Sven Fuest, Felix von Podewils, Rhina Kunz, Martin Hirsch, Tamara Mueller, Justus Marquetand, Yaroslav Winter, Lisa Langenbruch, Michal Cicanic, Stefan Beyenburg, Adam Strzelczyk, Susanne Knake
Format: Article
Language:English
Published: BMJ Publishing Group 2019-11-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/11/e030746.full
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author Katja Menzler
Peter Michael Mross
Felix Rosenow
Susanne Schubert-Bast
Laurent Maximilian Willems
Felix Zahnert
Ilka Immisch
Sven Fuest
Felix von Podewils
Rhina Kunz
Martin Hirsch
Tamara Mueller
Justus Marquetand
Yaroslav Winter
Lisa Langenbruch
Michal Cicanic
Stefan Beyenburg
Adam Strzelczyk
Susanne Knake
author_facet Katja Menzler
Peter Michael Mross
Felix Rosenow
Susanne Schubert-Bast
Laurent Maximilian Willems
Felix Zahnert
Ilka Immisch
Sven Fuest
Felix von Podewils
Rhina Kunz
Martin Hirsch
Tamara Mueller
Justus Marquetand
Yaroslav Winter
Lisa Langenbruch
Michal Cicanic
Stefan Beyenburg
Adam Strzelczyk
Susanne Knake
author_sort Katja Menzler
collection DOAJ
description Objectives Brivaracetam (BRV) is the latest approved antiepileptic drug and acts as a synaptic vesicle protein 2A ligand. The aim of the present study was to evaluate the efficacy and tolerability of BRV in the clinical setting.Design Retrospective, observational multicentre study.Setting We retrospectively collected clinical data of patients who received BRV in 10 epilepsy centres using a questionnaire that was answered by the reporting neurologist.Participants Data of 615 epilepsy patients treated with BRV were included in the study.Primary and secondary outcome measures Efficacy regarding seizure frequency and tolerability of BRV were evaluated. Descriptive statistics complemented by X2 contingency tests and effect sizes were performed.Results Overall, 44% of the patients had a decreased, 38% a stable and 18% an increased seizure frequency. 17% of patients achieved seizure freedom after initiation of BRV. The seizure frequency decreased in 63% of 19 patients with BRV monotherapy. 27% reported adverse effects, but only 10% of patients with monotherapy. Brivaracetam was significantly more often associated with decreased seizure frequency in levetiracetam (LEV) naïve patients (p=0.012), but BRV also led to a decreased seizure frequency in 42% of patients who had been treated with LEV before, including 17% of patients who were completely seizure free. Adverse effects under LEV improved in 62% and deteriorated in 2% of patients after the switch to BRV. At latest follow-up (mean±SD = 26.3±6.5 months), 68% were still on BRV.Conclusions The present study shows that results of the phase III studies on BRV match data from real life clinical settings. Brivaracetam seems to be a useful alternative in patients who have suffered adverse effects while taking LEV.
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spelling doaj-art-0847375cebf042dabe390de60cdfd1bd2025-08-20T02:05:35ZengBMJ Publishing GroupBMJ Open2044-60552019-11-0191110.1136/bmjopen-2019-030746First clinical postmarketing experiences in the treatment of epilepsies with brivaracetam: a retrospective observational multicentre studyKatja Menzler0Peter Michael Mross1Felix Rosenow2Susanne Schubert-Bast3Laurent Maximilian Willems4Felix Zahnert5Ilka Immisch6Sven Fuest7Felix von Podewils8Rhina Kunz9Martin Hirsch10Tamara Mueller11Justus Marquetand12Yaroslav Winter13Lisa Langenbruch14Michal Cicanic15Stefan Beyenburg16Adam Strzelczyk17Susanne Knake181 Epilepsy Center Hessen, Department of Neurology, Philipps-University Marburg, Marburg, Germany1 Epilepsy Center Hessen, Department of Neurology, Philipps-University Marburg, Marburg, Germany5Epilepsy Center Frankfurt Rhine-Main, Frankfurt, Germany2 Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Center of Neurology and Neurosurgery, University Hospital, Goethe-University Frankfurt, Frankfurt am Main, Germany2 Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Center of Neurology and Neurosurgery, University Hospital, Goethe-University Frankfurt, Frankfurt am Main, Germany1 Epilepsy Center Hessen, Department of Neurology, Philipps-University Marburg, Marburg, Germany1 Epilepsy Center Hessen, Department of Neurology, Philipps-University Marburg, Marburg, Germany1 Epilepsy Center Hessen, Department of Neurology, Philipps-University Marburg, Marburg, Germany5 Epilepsy Center Greifswald and Department of Neurology, Ernst-Moritz-Arndt-University, Greifswald, Germany5 Epilepsy Center Greifswald and Department of Neurology, Ernst-Moritz-Arndt-University, Greifswald, Germany6 Epilepsy Center, Faculty of Medicine, University of Freiburg, Freiburg, GermanyDepartment of Neurology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany8 Epilepsy Center Tuebingen, Department of Neurology, University Hospital Tuebingen, Tuebingen, Germany9 Epilepsy Center Mainz, Department of Neurology, Johannes Gutenberg-University Mainz, Mainz, Germany10 Department of Neurology, University of Münster, Münster, Germany11 Sächsisches Epilepsiezentrum Radeberg gGmbH, Kleinwachau, Germany12 Hospital Center of Luxembourg, Luxembourg, Luxembourg5Epilepsy Center Frankfurt Rhine-Main, Frankfurt, Germany3 Department of Neurology, Epilepsy Centre Hessen, Philipps-University Marburg, Marburg, GermanyObjectives Brivaracetam (BRV) is the latest approved antiepileptic drug and acts as a synaptic vesicle protein 2A ligand. The aim of the present study was to evaluate the efficacy and tolerability of BRV in the clinical setting.Design Retrospective, observational multicentre study.Setting We retrospectively collected clinical data of patients who received BRV in 10 epilepsy centres using a questionnaire that was answered by the reporting neurologist.Participants Data of 615 epilepsy patients treated with BRV were included in the study.Primary and secondary outcome measures Efficacy regarding seizure frequency and tolerability of BRV were evaluated. Descriptive statistics complemented by X2 contingency tests and effect sizes were performed.Results Overall, 44% of the patients had a decreased, 38% a stable and 18% an increased seizure frequency. 17% of patients achieved seizure freedom after initiation of BRV. The seizure frequency decreased in 63% of 19 patients with BRV monotherapy. 27% reported adverse effects, but only 10% of patients with monotherapy. Brivaracetam was significantly more often associated with decreased seizure frequency in levetiracetam (LEV) naïve patients (p=0.012), but BRV also led to a decreased seizure frequency in 42% of patients who had been treated with LEV before, including 17% of patients who were completely seizure free. Adverse effects under LEV improved in 62% and deteriorated in 2% of patients after the switch to BRV. At latest follow-up (mean±SD = 26.3±6.5 months), 68% were still on BRV.Conclusions The present study shows that results of the phase III studies on BRV match data from real life clinical settings. Brivaracetam seems to be a useful alternative in patients who have suffered adverse effects while taking LEV.https://bmjopen.bmj.com/content/9/11/e030746.full
spellingShingle Katja Menzler
Peter Michael Mross
Felix Rosenow
Susanne Schubert-Bast
Laurent Maximilian Willems
Felix Zahnert
Ilka Immisch
Sven Fuest
Felix von Podewils
Rhina Kunz
Martin Hirsch
Tamara Mueller
Justus Marquetand
Yaroslav Winter
Lisa Langenbruch
Michal Cicanic
Stefan Beyenburg
Adam Strzelczyk
Susanne Knake
First clinical postmarketing experiences in the treatment of epilepsies with brivaracetam: a retrospective observational multicentre study
BMJ Open
title First clinical postmarketing experiences in the treatment of epilepsies with brivaracetam: a retrospective observational multicentre study
title_full First clinical postmarketing experiences in the treatment of epilepsies with brivaracetam: a retrospective observational multicentre study
title_fullStr First clinical postmarketing experiences in the treatment of epilepsies with brivaracetam: a retrospective observational multicentre study
title_full_unstemmed First clinical postmarketing experiences in the treatment of epilepsies with brivaracetam: a retrospective observational multicentre study
title_short First clinical postmarketing experiences in the treatment of epilepsies with brivaracetam: a retrospective observational multicentre study
title_sort first clinical postmarketing experiences in the treatment of epilepsies with brivaracetam a retrospective observational multicentre study
url https://bmjopen.bmj.com/content/9/11/e030746.full
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