Levetiracetam: an innovative and cost-effective add-on drug for refractory partial epilepsy

Poorly-controlled epilepsy can have a significant negative impact on quality of life, clinically important changes are seen in patients emotional well-being, cognitive functioning, social functioning and energy/fatigue levels. Poorly-controlled epilepsy places an undue economic burden on the patient and community. Increased costs are seen in both direct and indirect healthcare costs (e.g., inpatient care and loss of earnings associated with time lost from work). Therefore, long-term efficacy and tolerability are key considerations when designing the patient's treatment regimen. Therapy can be individualized using both classical drugs and newer antiepileptics such as levetiracetam (Keppra, UCB Pharma Inc.), which is currently recommended as add-on therapy for partial-onset seizures. Studies have revealed characteristics that suggest levetiracetam is the first of a new class of antiepileptic drugs, differentiated by its innovative mechanism of action. Its efficacy and tolerability have enabled many patients who were refractory to treatment with other antiepileptic drugs to achieve long-term seizure freedom. Levetiracetam has a high long-term retention rate, a powerful measure of adverse events and efficacy over time. Another equally important benefit is ease of use, levetiracetam is administered twice-daily and has a simple titration regimen. Pharmacoeconomic data show that the incremental cost of treating patients with levetiracetam is low when compared with the benefits of seizure freedom. Ongoing studies suggest that this antiepileptic drug has potential as first-line treatment for many types of epilepsy and in many different patient populations.