Abstract
Objectives Assess effectiveness and tolerability of brivaracetam (BRV) in patients switching from levetiracetam (LEV) and from other antiseizure medications (ASMs).
Method Subgroup analysis of EXPERIENCE/EPD332, a pooled analysis of patient-level data from patients with epilepsy initiating BRV in clinical practice. ≥50% seizure reduction from baseline, seizure-freedom (SF; no seizures within 3 months prior to timepoint), continuous SF after baseline (CSF) and treatment-emergent adverse events (TEAEs) since prior visit were assessed at 12 months. Patients with missing data after BRV discontinuation were considered non-responders and not seizure-free.
Results 709 (43.8%) patients switched from LEV and 887 (54.8%) switched from other ASMs. Patients switching from LEV/other ASMs showed similar epilepsy duration (median: 18.0/17.0 years; n=694/864), seizure frequency at index (median: 4.0/4.3 seizures/28 days; n=537/807), number of prior ASMs (mean [SD]: 5.0 [3.7]/6.0 [3.9]; n=709/887) and incidence of psychiatric comorbidities at index (34.8%/39.7%; n=704/866). Most had focal-onset seizures at baseline (92.7%/91.9%). At index, median BRV dose was 100/50 mg/day in patients switching from LEV/other ASMs (n=699/869). Median BRV duration was 353.1/337.4 days (n=703/878). At 12 months, ≥50% seizure reduction (34.6%/38.3% [n=295/512]), SF (14.9%/13.9% [n=484/596]), CSF (11.4%/10.9% [n=484/596]) and incidence of TEAEs (9.5%/9.1%; n=525/662) were similar in patients switching from LEV/other ASMs. Somnolence (3.0%/1.7%) was the most common TEAE. The incidence of irritability was 1.3%/0.5%, and aggression was 0.8%/0.3%. BRV discontinuations in patients switching from LEV/other ASMs were 32.0%/35.8%; n=706/885).
Conclusion Effectiveness and tolerability of BRV were similar in patients switching from LEV/other ASMs.
Funding/Disclosures: UCB Pharma-sponsored.
