Pavel Klein, MD

“The idea would be for us to find a way of predicting which patient will respond to which particular medication so we can tailor the treatment specifically to that patient. And the same goes for side effects. “

Data from the post-hoc analysis of the randomized, double-blind, placebo-controlled (N01358; NCT01261325) and open-label extension (OLE; N01379; NCT01339559) trials investigating adjunctive brivaracetam (BRV) were presented at the American Epilepsy Society (AES) Annual Meeting, December 4–8, 2020.

Study investigator Pavel Klein, MD, director, Mid-Atlantic Epilepsy and Sleep Center, and colleagues presented data from the analysis that showed that in adults with focal seizures, retention rates of BRV were inversely proportional to the number of lifetime anti-epileptic drugs (AEDs). Patients with less lifetime AEDs were less likely to discontinue BRV due to lack of efficacy or treatment-emergent adverse events (TEAEs).

Long-term efficacy was highest in patients with 1–2 lifetime AEDs and decreased by the number of lifetime AEDs. Patients exposed to ≥7 AEDs still benefitted from long-term BRV treatment, although they had a lesser response to treatment with BRV. 

 spoke with Klein to learn more about determining patient populations that will respond well to BRV as well as predicting likelihood of TEAEs. Klein stressed getting to patients early in their disease course.

REFERENCE
Klein P, Dimova S, Brandt C, Laloyaux C, Nondonfaz X, Elmoufti S. Long-term retention, efficacy and tolerability of adjunctive brivaracetam by number of lifetime antiepileptic drugs in adults with focal seizures: A post hoc analysis. Presented at AES 2020 Annual Meeting; December 4–8, 2020. Abstract 134.

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The director of the Mid-Atlantic Epilepsy and Sleep Center discussed his team’s investigations into predicting responders and adverse events. 

Pavel Klein, MD: Determining Likelihood of Efficacy and AEs in Patient Populations

"You want to get to patients who show refractoriness of epilepsy as soon as you can and be as aggressive with your treatment choice as you can.”

Findings from a post-hoc analysis of the randomized, double-blind, placebo-controlled (N01358; NCT01261325) and open-label extension (OLE; N01379; NCT01339559) trials that investigated adjunctive brivaracetam (BRV) were presented at the 

American Epilepsy Society (AES) Annual Meeting

Among the study investigators is Pavel Klein, MD, director, Mid-Atlantic Epilepsy and Sleep Center. Klein and colleagues presented data from the analysis that showed that in adults with focal seizure, patients were more likely to discontinue BRV the greater number of lifetime anti-epileptic drugs (AEDs) they had been exposed to, and that discontinuation due to lack of efficacy or treatment-emergent adverse events (TEAEs) was less likely.

Klein and colleagues found that retention rates of BRV were inversely proportional to the number of lifetime AEDs and that long-term efficacy was highest in patients with 1–2 lifetime AEDs and decreased by the number of lifetime AEDs. Patients exposed to ≥7 AEDs still seen to benefit from long-term BRV treatment, although they had a lesser response to treatment with BRV.

 spoke with Klein to learn more about managing refractory epilepsy and the importance of trying different treatments in order to find the best efficacy possible for patients. He urged physicians to not be complacent in the search for AEDs.

The director of the Mid-Atlantic Epilepsy and Sleep Center urged physicians to catch refractory epilepsy early and look for the most efficacious treatments for their patients.

Pavel Klein, MD: Finding the Right AEDs for Patients With Epilepsy

"One lesson I would draw from the study is that you really do want to try to get to patients early on.”

American Epilepsy Society (AES) Annual Meeting, December 4–8, 2020

 was a post-hoc analysis of the randomized, double-blind, placebo-controlled (N01358; NCT01261325) and open-label extension (OLE; N01379; NCT01339559) trials of adjunctive brivaracetam (BRV). Pavel Klein, MD, director, Mid-Atlantic Epilepsy and Sleep Center, presented data from the analysis that showed that retention rates of BRV were inversely proportional to the number of anti-epileptic drugs (AEDs) that adults with focal seizures had previously been exposed to.

Klein and colleagues found that patients with a lesser history of AEDs were less likely to discontinue BRV due to lack of efficacy or treatment-emergent adverse events (TEAEs), and that long-term efficacy was highest in patients with 1–2 lifetime AEDs and decreased by number of lifetime AEDs. While patients exposed to ≥7 AEDs had a lesser response to BRV, they were still seen to benefit from long-term BRV treatment.

NeurologyLive spoke with Klein to learn more about BRV and its efficacy in patients with different numbers of lifetime AEDs. He noted that while the greatest response was seen in patients who had taken up to 1 or 2 AEDs, efficacy was still seen in patients who had been administered more than 7 AEDs.

Klein P, Dimova S, Brandt C, Laloyaux C, Nondonfaz X, Elmoufti S. Long-term retention, efficacy and tolerability of adjunctive brivaracetam by number of lifetime antiepileptic drugs in adults with focal seizures: A post hoc analysis. Presented at AES 2020 Annual Meeting; December 4–8, 2020. Abstract 134.

The director of the Mid-Atlantic Epilepsy and Sleep Center urged physicians to try and find the right medications for their patients as early as possible. 

Pavel Klein, MD: Brivaracetam Efficacy Inversely Proportional to Number of Lifetime AEDs

"The longer the patient has gone down the road of refractory epilepsy, the greater the number of medications that they have failed, the more difficult it is. But one of the challenges is to not give up.”

A post-hoc analysis of the randomized, double-blind, placebo-controlled (N01358; NCT01261325) and open-label extension (OLE; N01379; NCT01339559) trials of adjunctive brivaracetam (BRV) was presented at the 

. Data from this analysis demonstrated that retention rates of BRV were inversely proportional to the number of anti-epileptic drugs (AEDs) that adults with focal seizures had previously been exposed to. Patients with a lesser history of AEDs were less likely to discontinue BRV due to lack of efficacy or treatment-emergent adverse events (TEAEs).

Pavel Klein, MD, director, Mid-Atlantic Epilepsy and Sleep Center, presented his findings that showed that long-term efficacy was highest in patients with 1–-2 lifetime AEDs and decreased by number of lifetime AEDs, though patients exposed to ≥7 AEDs still benefitted from long-term BRV treatment.

 spoke with Klein to learn more about BRV and its efficacy in patients with drug resistant epilepsy. He stressed the importance of not giving up or settling on epilepsy treatments and urged physicians to always be on the lookout for medications that may be more effective for their patients.

The director of the Mid-Atlantic Epilepsy and Sleep Center urged physicians to actively look for new medications for patients to try.  

Pavel Klein, MD

Articles

Pavel Klein, MD: Determining Likelihood of Efficacy and AEs in Patient Populations

Pavel Klein, MD: Finding the Right AEDs for Patients With Epilepsy

Pavel Klein, MD: Brivaracetam Efficacy Inversely Proportional to Number of Lifetime AEDs

Pavel Klein, MD: Efficacy of Brivaracetam on Refractory Epilepsy