KWAN, Patrick, Eugen TRINKA, Wim Van PAESSCHEN, Ivan REKTOR, Martin E. JOHNSON and Sarah LU. Adjunctive brivaracetam for uncontrolled focal and generalized epilepsies: Results of a phase III, double-blind, randomized, placebo-controlled, flexible-dose trial. Epilepsia. Hoboken, USA: WILEY-BLACKWELL, 2014, vol. 55, No 1, p. 38-46. ISSN 0013-9580. Available from: https://dx.doi.org/10.1111/epi.12391.
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Basic information
Original name Adjunctive brivaracetam for uncontrolled focal and generalized epilepsies: Results of a phase III, double-blind, randomized, placebo-controlled, flexible-dose trial
Authors KWAN, Patrick (344 Hong Kong), Eugen TRINKA (40 Austria), Wim Van PAESSCHEN (56 Belgium), Ivan REKTOR (203 Czech Republic, guarantor, belonging to the institution), Martin E. JOHNSON (840 United States of America) and Sarah LU (840 United States of America).
Edition Epilepsia, Hoboken, USA, WILEY-BLACKWELL, 2014, 0013-9580.
Other information
Original language English
Type of outcome Article in a journal
Field of Study 30000 3. Medical and Health Sciences
Country of publisher United States of America
Confidentiality degree is not subject to a state or trade secret
WWW URL
Impact factor Impact factor: 4.571
RIV identification code RIV/00216224:14740/14:00074858
Organization unit Central European Institute of Technology
Doi http://dx.doi.org/10.1111/epi.12391
UT WoS 000329893900006
Keywords in English Brivaracetam; Epilepsy; Seizures; Antiepileptic drug; Synaptic vesicle protein 2A
Tags kontrola MP, ok, rivok
Tags International impact, Reviewed
Changed by Changed by: Olga Křížová, učo 56639. Changed: 20/3/2014 09:22.
Abstract
PurposeTo evaluate the safety and tolerability of adjunctive brivaracetam (BRV), a high-affinity synaptic vesicle protein 2A (SV2A) ligand, in adults with uncontrolled epilepsy. Efficacy was also assessed in patients with focal seizures as a secondary objective, and explored by descriptive analysis in patients with generalized seizures. MethodsThis was a phase III, randomized, double-blind, placebo (PBO)-controlled flexible dose trial (N01254/NCT00504881) in adults (16-70years) with uncontrolled epilepsy (up to 20% could be patients with generalized epilepsy). After a prospective 4-week baseline, patients were randomized (3:1) to b.i.d. BRV or PBO, initiated at 20mg/day and increased, as needed, to 150mg/day during an 8-week dose-finding period. This was followed by an 8-week stable-dose maintenance period. The treatment period comprised the dose-finding period plus the maintenance period (16weeks). Key FindingsA total of 480 patients were randomized (BRV 359, PBO 121); of these, 431 had focal epilepsy and 49 had generalized epilepsy. Ninety percent BRV- and 91.7% PBO-treated patients completed the study. Similar proportions of patients (BRV 66.0%, PBO 65.3%) reported adverse events (AEs) during the treatment period. AEs led to treatment discontinuation in 6.1% and 5.0% of BRV- and PBO-treated patients, respectively. The incidence of AEs declined from the dose-finding (BRV 56.0%, PBO 55.4%) to the maintenance (BRV 36.8%, PBO 40.9%) period. The most frequent AEs during the treatment period were headache (BRV 14.2% vs. PBO 19.8%), somnolence (BRV 11.1% vs. PBO 4.1%), and dizziness (BRV 8.6% vs. PBO 5.8%). The incidence of psychiatric AEs was similar for BRV and PBO (BRV 12.3%, PBO 11.6%). In patients with focal seizures, the baseline-adjusted percent reduction in seizure frequency/week in the BRV group (n=323) over PBO (n=108) was 7.3% (p=0.125) during the treatment period. The median percent reduction in baseline-adjusted seizure frequency/week was 26.9% BRV versus 18.9% PBO (p=0.070), and the 50% responder rate was 30.3% BRV versus 16.7% PBO (p=0.006). In patients with generalized seizures only, the number of seizure days/week decreased from 1.42 at baseline to 0.63 during the treatment period in BRV-treated patients (n=36), and from 1.47 at baseline to 1.26 during the treatment period in PBO-treated patients (n=13). The median percent reduction from baseline in generalized seizure days/week was 42.6% versus 20.7%, and the 50% responder rate was 44.4% versus 15.4% in BRV-treated and PBO-treated patients, respectively. SignificanceAdjunctive BRV given at individualized tailored doses (20-150mg/day) was well tolerated in adults with uncontrolled epilepsy, and our results provided support for further evaluation of efficacy in reducing focal and generalized seizures.
Links
ED1.1.00/02.0068, research and development projectName: CEITEC - central european institute of technology
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