Brivaracetam use in children with epilepsy: A retrospective multicenter study

Area of Science:

• Neurology
• Pediatric Epilepsy Research
• Pharmacology

Background:

• Pediatric epilepsy encompasses a wide spectrum of conditions, often requiring multiple antiseizure medications (ASMs).
• Drug-resistant epilepsy in children presents significant management challenges.
• Assessing novel ASMs like brivaracetam (BRV) is crucial for improving treatment outcomes.

Purpose of the Study:

• To evaluate the efficacy and safety of brivaracetam (BRV) in a diverse pediatric epilepsy cohort.
• To determine treatment retention rates and response rates to BRV.
• To assess the impact of BRV on behavioral adverse effects when switching from levetiracetam (LEV).

Main Methods:

• Retrospective multicenter study of 93 pediatric epilepsy patients (mean age 11.5 years).
• Inclusion of various epilepsy types, including focal, generalized, combined, and rare syndromes (Lennox-Gastaut, Dravet, Rasmussen).
• Analysis of treatment retention, response rates, and adverse events (AEs) over 12 months.

Main Results:

• High treatment retention: 80.6% at 3 months, 66.7% at 6 months, 45.2% at 12 months.
• Overall response rate of 25.8% at 3 months, with the best response in focal epilepsy; no response in epileptic encephalopathy.
• Good tolerability: 75.3% reported no AEs; 14.0% required dose adjustment/discontinuation due to AEs.

Conclusions:

• Brivaracetam (BRV) is effective in approximately one-fifth of pediatric patients with drug-resistant epilepsy, especially those with focal seizures.
• BRV demonstrated limited efficacy in patients with epileptic encephalopathy.
• The drug was generally well-tolerated, with a notable reduction in behavioral adverse effects in some patients switching from levetiracetam.