Pavel Klein, MD: Efficacy of Brivaracetam on Refractory Epilepsy


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

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

NeurologyLive 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.

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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