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


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

“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. 

NeurologyLive 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.

For more coverage of AES 2020, click here.

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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