Department of Pediatrics, University of Perugia, Perugia, Italy.
Department of Pediatrics, University of L'Aquila, L'Aquila, Italy.
Expert Opin Pharmacother. 2021 Aug;22(11):1387-1395. doi: 10.1080/14656566.2021.1921151. Epub 2021 May 12.
: Brivaracetam (BRV) is an antiseizure medication (ASM), which has been approved as an adjunctive treatment in adults and pediatric patients aged four years and older with focal onset seizures. It is a second-generation levetiracetam (LEV) derivative, sharing the same mechanism of action, binding synaptic vesicles 2A (SV2A). BRV shows higher binding affinity and selectivity and higher brain permeability than LEV.: This article reviews randomized controlled trials, retrospective and prospective studies published up to December 2020, searched in electronic databases MEDLINE, EMBASE and the Clinical Trial Database and provide an overview of efficacy, safety and tolerability of BRV in pediatric patients with partial epilepsy. Furthermore, the authors provide their expert opinion on the drug and give their future perspectives.: The analysis of the literature data has demonstrated the safety and efficacy of BRV in pediatric patients, with more evidence in children aged 4 to 16 years with an onset of focal seizures. However, a positive response was also achieved in patients affected by some encephalopathic epilepsies. Comparative efficacy studies between BRV and other ASMs, in addition to well-designed RCTs that include larger pediatric populations are needed to better define the role and potentiality of this ASM.
布瓦西坦（BRV）是一种抗癫痫药物（ASM），已被批准作为辅助治疗药物，适用于 4 岁及以上患有局灶性发作性癫痫的成年和儿科患者。它是第二代左乙拉西坦（LEV）衍生物，具有相同的作用机制，与突触小泡 2A（SV2A）结合。BRV 与 LEV 相比，具有更高的结合亲和力和选择性，以及更高的脑通透性。本文综述了截至 2020 年 12 月发表的随机对照试验、回顾性和前瞻性研究，检索了 MEDLINE、EMBASE 和临床试验数据库中的电子数据库，并概述了 BRV 在局灶性癫痫儿科患者中的疗效、安全性和耐受性。此外，作者还对该药物发表了专家意见，并对其未来前景进行了展望。对文献数据的分析表明，BRV 在儿科患者中的安全性和疗效良好，在 4 至 16 岁起病的局灶性癫痫儿童中证据更为充分。然而，在一些脑病性癫痫患者中也取得了积极的反应。需要进行 BRV 与其他 ASM 的疗效比较研究，以及包括更大儿科人群的精心设计的 RCT，以更好地确定这种 ASM 的作用和潜力。
