Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy.
Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy.
Epilepsia. 2022 May;63(5):e42-e50. doi: 10.1111/epi.17223. Epub 2022 Mar 26.
The maintenance of seizure control over time is a clinical priority in patients with epilepsy. The aim of this study was to assess the sustained seizure frequency reduction with adjunctive brivaracetam (BRV) in real-world practice. Patients with focal epilepsy prescribed add-on BRV were identified. Study outcomes included sustained seizure freedom and sustained seizure response, defined as a 100% and a ≥50% reduction in baseline seizure frequency that continued without interruption and without BRV withdrawal through the 12-month follow-up. Nine hundred ninety-four patients with a median age of 45 (interquartile range = 32-56) years were included. During the 1-year study period, sustained seizure freedom was achieved by 142 (14.3%) patients, of whom 72 (50.7%) were seizure-free from Day 1 of BRV treatment. Sustained seizure freedom was maintained for ≥6, ≥9, and 12 months by 14.3%, 11.9%, and 7.2% of patients from the study cohort. Sustained seizure response was reached by 383 (38.5%) patients; 236 of 383 (61.6%) achieved sustained ≥50% reduction in seizure frequency by Day 1, 94 of 383 (24.5%) by Month 4, and 53 of 383 (13.8%) by Month 7 up to Month 12. Adjunctive BRV was associated with sustained seizure frequency reduction from the first day of treatment in a subset of patients with uncontrolled focal epilepsy.
在癫痫患者中，随着时间的推移维持癫痫发作的控制是临床的首要任务。本研究旨在评估附加使用溴维瑞坦（BRV）对现实实践中持续性癫痫发作频率的降低作用。确定了接受附加 BRV 治疗的局灶性癫痫患者。研究结果包括持续性无癫痫发作和持续性癫痫反应，定义为基线癫痫发作频率降低 100%和≥50%，持续不间断，并且在 12 个月的随访过程中无需中断 BRV 治疗。纳入了 994 名中位年龄为 45 岁（四分位距=32-56）的患者。在 1 年的研究期间，142 名（14.3%）患者达到了持续性无癫痫发作，其中 72 名（50.7%）从开始使用 BRV 治疗的第 1 天起就无癫痫发作。在研究队列中，有 14.3%、11.9%和 7.2%的患者分别在第 6、9 和 12 个月维持了≥6、≥9 和 12 个月的持续性无癫痫发作。383 名（38.5%）患者达到了持续性癫痫反应；383 名患者中有 236 名（61.6%）在第 1 天达到了持续的癫痫发作频率降低≥50%，94 名（24.5%）在第 4 个月达到了这一标准，53 名（13.8%）在第 7 个月到第 12 个月达到了这一标准。在一组未得到控制的局灶性癫痫患者中，附加使用溴维瑞坦可从治疗的第 1 天开始持续降低癫痫发作频率。
