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

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

Among the many studies presented at the 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.

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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.