Department of Residential Care, Epilepsy Center Kempenhaeghe, Postbus 61, 5590 AB, Heeze, The Netherlands.
Department of Pharmacy, Academic Center for Epileptology Kempenhaeghe, Postbus 61, 5590 AB, Heeze, The Netherlands.
Acta Neurol Belg. 2021 Jun;121(3):677-684. doi: 10.1007/s13760-020-01324-3. Epub 2020 Mar 10.
Patients with intellectual disability (ID) are often excluded from clinical trials, and little is known about the best approach to treat their epilepsy. Brivaracetam (BRV) is a new antiepileptic drug (AED) for adjunctive treatment in patients with focal-onset seizures with or without secondary generalization. We analyzed the efficacy and tolerability of BRV in patients with ID and epilepsy who either had or had not previously received treatment with levetiracetam (LEV). Data on efficacy and tolerability were retrospectively collected. After the initial start of BRV in our tertiary epilepsy center, we analyzed medical records at 0, 3, 6 and 12 months of follow-up. 116 patients were included (mean age = 34.9 years, 44% female). All had complete data of 3-month follow-up, 76 of 6-month follow-up, and 39 patients of 1-year follow-up. Median starting dose of BRV was 50.0 mg/day and the mean number of concomitant AEDs was 2.6. Seizure reduction and no side effects were reported in more than half of all patients. The most reported side effects were somnolence, dizziness and aggression. Retention rates for BRV were 84.4%, 75.5% and 58.1% after 3, 6 and 12 months, respectively. Seizure reduction and side effects did not differ significantly between the groups with or without previous LEV treatment. We demonstrate that BRV is effective and well tolerated in patients with epilepsy and ID, even in those where previous LEV treatment failed.
患有智力障碍 (ID) 的患者通常被排除在临床试验之外，对于如何最好地治疗他们的癫痫知之甚少。布瓦雷他（BRV）是一种新的抗癫痫药物 (AED)，适用于局灶性发作伴或不伴继发全面性发作的患者。我们分析了 BRV 在有或没有先前接受左乙拉西坦（LEV）治疗的 ID 和癫痫患者中的疗效和耐受性。回顾性收集了疗效和耐受性的数据。在我们的三级癫痫中心开始使用 BRV 后，我们分析了随访 0、3、6 和 12 个月的病历。共纳入 116 例患者（平均年龄 34.9 岁，女性占 44%）。所有患者均有 3 个月随访的完整数据，76 例有 6 个月随访的数据，39 例有 1 年随访的数据。BRV 的起始剂量中位数为 50.0mg/天，平均合用的 AED 数量为 2.6 种。超过一半的患者报告癫痫发作减少且无副作用。报告最多的副作用是嗜睡、头晕和攻击性。BRV 在 3、6 和 12 个月后的保留率分别为 84.4%、75.5%和 58.1%。在有或没有先前 LEV 治疗的患者中，癫痫发作减少和副作用没有显著差异。我们证明 BRV 对癫痫和 ID 患者有效且耐受性良好，即使在先前 LEV 治疗失败的患者中也是如此。
