An update on brivaracetam for the treatment of pediatric partial epilepsy
Eleonora Tulli1, Giuseppe Di Cara1, Giulia Iapadre2
1Department of Pediatrics, University of Perugia, Perugia, Italy.
Insights
Brivaracetam (BRV) is an effective and safe antiseizure medication for pediatric focal epilepsy. Further research is needed to confirm its role in broader pediatric epilepsy populations.
Area of Science:
- Neurology
- Pharmacology
Background:
- Brivaracetam (BRV) is a second-generation antiseizure medication (ASM) derived from levetiracetam (LEV).
- BRV targets synaptic vesicle 2A (SV2A) with higher affinity and selectivity than LEV.
- It exhibits enhanced brain permeability compared to LEV.
Purpose of the Study:
- To review the efficacy, safety, and tolerability of BRV in pediatric patients with focal onset seizures.
- To provide an expert opinion on the current evidence and future perspectives for BRV in pediatric epilepsy.
Main Methods:
- Systematic review of randomized controlled trials, retrospective, and prospective studies published up to December 2020.
- Searches conducted in MEDLINE, EMBASE, and the Clinical Trial Database.
Main Results:
- BRV demonstrated safety and efficacy in pediatric patients, particularly those aged 4 to 16 years with focal onset seizures.
- Positive responses were also observed in some patients with encephalopathic epilepsies.
- The literature analysis supports BRV's utility as an adjunctive treatment.
Conclusions:
- Brivaracetam is a safe and effective adjunctive treatment for pediatric focal onset seizures.
- Further comparative efficacy studies and well-designed randomized controlled trials with larger pediatric populations are warranted.
- Defining the role of BRV in broader pediatric epilepsy syndromes requires additional investigation.
Abstract:
Introduction: 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.Areas covered: 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.Expert opinion: 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.
More Related Videos
09:57Author Spotlight: Advancing Pediatric Epilepsy Surgery in Children Through Novel Biomarkers and Enhanced Localization
Published on: September 20, 2024
08:36Author Spotlight: Evaluating the Adjuvant Efficacy and Safety of Angong Niuhuang Pill in Viral Encephalitis Treatment
Published on: April 19, 2024
Related Concept Videos
01:20Antiepileptic Drugs: Modulators of Neurotransmitter Release Mediated by SV2A Protein
SV2A is a transmembrane glycoprotein located predominantly in the brain, modulating the release of neurotransmitters for neuronal communication. Both levetiracetam and brivaracetam exhibit a high affinity for...
01:18Antiepileptic Drugs: GABAergic Pathway Potentiators
The key GABA pathway potentiators used in epilepsy management are as follows.
Benzodiazepines are a well-known class of drugs used for...
01:24Pharmacokinetics in Pediatric Patients: Drug Metabolism
01:23Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
01:29Drug Dosing: Infants and Children
01:24Epilepsy and Seizures: Overview
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...