Rx Shows Promise for Epilepsy Patients

Brivaracetam may reduce epilepsy seizure rate by almost a quarter

(RxWiki News) Epilepsy patients may have a new way to fight seizures. A new medication may reduce the number of seizures these patients have.

Although anti-epileptic therapy continues to be developed, many adults with epilepsy struggle with seizure control. A new medication called brivaracetam, which is still being tested, has been reducing seizure episodes in patients, a new study found.

"Brivaracetam has a similar mechanism of action as levetiracetam, a very successful anti-epileptic drug approved in 2000," said Jorge Asconape, MD, a Loyola University Medical Center neurologist who specializes in epilepsy.

"The hope is that brivaracetam will have fewer psychiatric side effects than levetiracetam," said Dr. Asconape, who was not involved in this study. "Brivaracetam’s efficacy in controlling seizures is equivalent to a number of other newer anti-epileptic drugs. An abundance of these newer drugs is providing physicians with an opportunity to better meet the needs of more patients."

Pavel Klein, MD, director of the Mid-Atlantic Epilepsy and Sleep Center in Bethesda, MD, and colleagues presented the results of their study at the American Epilepsy Society Annual Meeting in Seattle.

“This first presentation of primary study results from the latest Phase 3 brivaracetam study is highly anticipated in the epilepsy community,” Dr. Klein said in a press release. “The two primary outcomes in this study evaluating adjunctive brivaracetam in the treatment of partial-onset seizures in adults with epilepsy were statistically significant and clinically relevant.”

About 3 million people have epilepsy in the US, according to CURE Epilepsy — including Neil Young, Rick Harrison (of the TV show "Pawn Stars"), Prince and the rapper Lil Wayne. As these celebrities demonstrate, epilepsy can be controlled, and patients can lead productive lives.

Epilepsy is a brain disorder in which groups of nerve cells (neurons) in the brain sometimes signal abnormally. This misfiring of neurons can sometimes cause convulsions, or seizures.

About 25 to 30 percent of people with epilepsy continue to have seizures even with the best available treatment, according to the National Institute of Neurological Disorders and Stroke. Brivaracetam may offer a solution for these patients. Dr. Klein and team's recent trials of this medication found a significant reduction of seizures in epilepsy patients who took the medication.

A total of 764 epilepsy patients received either 100 milligrams (mg) per day of brivaracetam, 200 mg per day of the medication or a fake (placebo) pill. All were already taking one or two other anti-epileptic medications. The brivaracetam was given to enhance their primary treatment.

For more than 8 out of 10 of these patients, at least two prior anti-epilepsy medications had failed to work. Almost half of the patients reported no success with five or more available anti-epilepsy treatments.

The patients took brivaracetam for 12 weeks. During this time, Dr. Klein and team assessed seizure reduction based on patient entries in seizure diaries. Compared to the placebo group, patients taking 100 mg of the medication had 23 percent fewer seizures over a 28-day period. Those taking 200 mg of brivaracetam saw a similar drop in seizures.

Dr. Klein and colleagues noted that the findings remained consistent regardless of prior exposure to levetiracetam (brand name Keppra). Levetiracetam is an anticonvulsant used in combination with other medications to treat certain types of seizures in people with epilepsy.

A total of 25 patients achieved a complete stop of all seizures. These included 13 from the 100 mg group, 10 from the 200 mg group and two from the placebo group.

Overall, patients tolerated the medication well, Dr. Klein and colleagues said. Dizziness, fatigue, headache, sleepiness and other adverse events occurred in 7 to 19 percent of people taking 100 mg and in 8 to 16 percent of those taking 200 mg of brivaracetam.

Dr. Klein and team concluded that brivaracetam at 100 mg and 200 mg produced significant reductions in seizure rates.

This study was presented Dec. 7 at the American Epilepsy Society Annual Meeting in Seattle. Research presented at conferences may not have been peer-reviewed.

The authors disclosed no funding sources or conflicts of interest.

Review Date: 
December 7, 2014
Last Updated:
December 12, 2014