Adjunctive Brivaracetam in People with Epilepsy and Intellectual Disability: Evidence from the BRIVAracetam Add-On First Italian netwoRk Study

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 epilep...

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Main Authors: Simona Lattanzi, Laura Canafoglia, Maria Paola Canevini, Sara Casciato, Emanuele Cerulli Irelli, Valentina Chiesa, Filippo Dainese, Giovanni De Maria, Giuseppe Didato, Giancarlo Di Gennaro, Giovanni Falcicchio, Martina Fanella, Edoardo Ferlazzo, Massimo Gangitano, Angela La Neve, Oriano Mecarelli, Elisa Montalenti, Alessandra Morano, Federico Piazza, Chiara Pizzanelli, Patrizia Pulitano, Federica Ranzato, Eleonora Rosati, Laura Tassi, Carlo Di Bonaventura, on behalf of BRIVAracetam add‑on First Italian netwoRk Study (BRIVAFIRST) Group Membership
Format: Article
Language:English
Published: Adis, Springer Healthcare 2025-03-01
Series:Neurology and Therapy
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Online Access:https://doi.org/10.1007/s40120-025-00717-x
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author Simona Lattanzi
Laura Canafoglia
Maria Paola Canevini
Sara Casciato
Emanuele Cerulli Irelli
Valentina Chiesa
Filippo Dainese
Giovanni De Maria
Giuseppe Didato
Giancarlo Di Gennaro
Giovanni Falcicchio
Martina Fanella
Edoardo Ferlazzo
Massimo Gangitano
Angela La Neve
Oriano Mecarelli
Elisa Montalenti
Alessandra Morano
Federico Piazza
Chiara Pizzanelli
Patrizia Pulitano
Federica Ranzato
Eleonora Rosati
Laura Tassi
Carlo Di Bonaventura
on behalf of BRIVAracetam add‑on First Italian netwoRk Study (BRIVAFIRST) Group Membership
author_facet Simona Lattanzi
Laura Canafoglia
Maria Paola Canevini
Sara Casciato
Emanuele Cerulli Irelli
Valentina Chiesa
Filippo Dainese
Giovanni De Maria
Giuseppe Didato
Giancarlo Di Gennaro
Giovanni Falcicchio
Martina Fanella
Edoardo Ferlazzo
Massimo Gangitano
Angela La Neve
Oriano Mecarelli
Elisa Montalenti
Alessandra Morano
Federico Piazza
Chiara Pizzanelli
Patrizia Pulitano
Federica Ranzato
Eleonora Rosati
Laura Tassi
Carlo Di Bonaventura
on behalf of BRIVAracetam add‑on First Italian netwoRk Study (BRIVAFIRST) Group Membership
author_sort Simona Lattanzi
collection DOAJ
description 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.
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spelling doaj-art-d8bb1a5e9d7440d5a83ffe5c2300ca1e2025-08-20T03:47:45ZengAdis, Springer HealthcareNeurology and Therapy2193-82532193-65362025-03-0114377578610.1007/s40120-025-00717-xAdjunctive Brivaracetam in People with Epilepsy and Intellectual Disability: Evidence from the BRIVAracetam Add-On First Italian netwoRk StudySimona Lattanzi0Laura Canafoglia1Maria Paola Canevini2Sara Casciato3Emanuele Cerulli Irelli4Valentina Chiesa5Filippo Dainese6Giovanni De Maria7Giuseppe Didato8Giancarlo Di Gennaro9Giovanni Falcicchio10Martina Fanella11Edoardo Ferlazzo12Massimo Gangitano13Angela La Neve14Oriano Mecarelli15Elisa Montalenti16Alessandra Morano17Federico Piazza18Chiara Pizzanelli19Patrizia Pulitano20Federica Ranzato21Eleonora Rosati22Laura Tassi23Carlo Di Bonaventura24on behalf of BRIVAracetam add‑on First Italian netwoRk Study (BRIVAFIRST) Group MembershipNeurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic UniversityDepartment of Epileptology, Fondazione IRCCS Istituto Neurologico Carlo BestaEpilepsy Center, Child Neuropsychiatry Unit, AAST Santi Paolo CarloIRCCS NeuromedDepartment of Human Neurosciences, Policlinico Umberto I, Sapienza University of RomeEpilepsy Center, Child Neuropsychiatry Unit, AAST Santi Paolo CarloEpilepsy Centre, Neurology UnitClinical Neurophysiology Unit, Epilepsy Center, Spedali CiviliEpilepsy Unit, Fondazione IRCCS Istituto Neurologico “Carlo Besta”IRCCS NeuromedDepartment of Basic Medical Sciences, Neurosciences and Sense Organs-University Hospital of Bari “A. Moro”Department of Human Neurosciences, Policlinico Umberto I, Sapienza University of RomeDepartment of Medical and Surgical Sciences, Magna Græcia University of CatanzaroDepartment of Biomedicine, Neuroscience, and Advanced Diagnostic (BIND), University of PalermoDepartment of Basic Medical Sciences, Neurosciences and Sense Organs-University Hospital of Bari “A. Moro”Department of Human Neurosciences, Policlinico Umberto I, Sapienza University of RomeEpilepsy Center, AOU Città della Salute e della Scienza di TorinoDepartment of Human Neurosciences, Policlinico Umberto I, Sapienza University of Rome“Rita Levi Montalcini” Department of Neurosciences, University of TurinDepartment of Translational Research On New Technologies in Medicine and Surgery, University of PisaDepartment of Human Neurosciences, Policlinico Umberto I, Sapienza University of RomeEpilepsy Center, UOC Neurology, AULSSDepartment of Neurofarba, University of Florence“C. Munari” Epilepsy Surgery Centre, Niguarda HospitalDepartment of Human Neurosciences, Policlinico Umberto I, Sapienza University of RomeAbstract 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.https://doi.org/10.1007/s40120-025-00717-xAntiseizure medicationBrivaracetamFocal seizuresEpilepsyIntellectual disability
spellingShingle Simona Lattanzi
Laura Canafoglia
Maria Paola Canevini
Sara Casciato
Emanuele Cerulli Irelli
Valentina Chiesa
Filippo Dainese
Giovanni De Maria
Giuseppe Didato
Giancarlo Di Gennaro
Giovanni Falcicchio
Martina Fanella
Edoardo Ferlazzo
Massimo Gangitano
Angela La Neve
Oriano Mecarelli
Elisa Montalenti
Alessandra Morano
Federico Piazza
Chiara Pizzanelli
Patrizia Pulitano
Federica Ranzato
Eleonora Rosati
Laura Tassi
Carlo Di Bonaventura
on behalf of BRIVAracetam add‑on First Italian netwoRk Study (BRIVAFIRST) Group Membership
Adjunctive Brivaracetam in People with Epilepsy and Intellectual Disability: Evidence from the BRIVAracetam Add-On First Italian netwoRk Study
Neurology and Therapy
Antiseizure medication
Brivaracetam
Focal seizures
Epilepsy
Intellectual disability
title Adjunctive Brivaracetam in People with Epilepsy and Intellectual Disability: Evidence from the BRIVAracetam Add-On First Italian netwoRk Study
title_full Adjunctive Brivaracetam in People with Epilepsy and Intellectual Disability: Evidence from the BRIVAracetam Add-On First Italian netwoRk Study
title_fullStr Adjunctive Brivaracetam in People with Epilepsy and Intellectual Disability: Evidence from the BRIVAracetam Add-On First Italian netwoRk Study
title_full_unstemmed Adjunctive Brivaracetam in People with Epilepsy and Intellectual Disability: Evidence from the BRIVAracetam Add-On First Italian netwoRk Study
title_short Adjunctive Brivaracetam in People with Epilepsy and Intellectual Disability: Evidence from the BRIVAracetam Add-On First Italian netwoRk Study
title_sort adjunctive brivaracetam in people with epilepsy and intellectual disability evidence from the brivaracetam add on first italian network study
topic Antiseizure medication
Brivaracetam
Focal seizures
Epilepsy
Intellectual disability
url https://doi.org/10.1007/s40120-025-00717-x
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