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Brivaracetam: A Review in Partial-Onset (Focal) Seizures in Patients with Epilepsy

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Abstract

Brivaracetam (Briviact®; BRIVLERA™) is a high affinity synaptic vesicle protein 2A (SV2A) ligand available orally (as a tablet or solution) or intravenously (as a bolus or infusion) in various countries worldwide, including the USA, Canada and those of the EU. It is approved as adjunctive therapy for the treatment of partial-onset seizures (POS) in adults (aged ≥18 years) [USA, EU and Canada] and adolescents (aged 16 to <18 years) [USA and EU] with epilepsy. In multinational, phase III studies in adults and adolescents (aged ≥16 years), oral brivaracetam as adjunctive therapy to other antiepileptic drugs (AEDs) was generally associated with significant median percent reductions over placebo in seizure frequency and significant improvements in the proportion of patients achieving a ≥50 % reduction in seizure frequency compared with placebo. These benefits appeared to be sustained during up to 96 months’ therapy in follow-up studies. Whether administered orally or intravenously, adjunctive brivaracetam was generally well tolerated in clinical studies, with the majority of treatment-emergent adverse events (TEAEs) being mild or moderate in intensity. In the absence of head-to-head studies, definitive conclusions on the comparative efficacy and tolerability of brivaracetam versus newer AEDs are not yet possible. In the meantime, brivaracetam extends the options currently available for the treatment of POS in patients aged ≥16 years with epilepsy.

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Acknowledgments

During the peer review process, the manufacturer of brivaracetam was also offered an opportunity to review this article. Changes resulting from comments received were made on the basis of scientific and editorial merit.

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    Sheridan M. Hoy

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  1. Sheridan M. Hoy
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Correspondence to Sheridan M. Hoy.

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The preparation of this review was not supported by any external funding.

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Sheridan Hoy is a salaried employee of Adis/Springer, is responsible for the article content and declares no relevant conflicts of interest.

Additional information

The manuscript was reviewed by: F. M. C. Besag, ELFT Family Consultation Clinic, Bedford, UK; K. Haas, Department of Neurology, Vanderbilt University School of Medicine, Nashville, TN, USA; P. Kwan, Department of Medicine, University of Melbourne and Royal Melbourne Hospital, Parkville, Victoria, Australia; M. Mula, Atkinson Morley Regional Neuroscience Centre, St George’s University Hospitals NHS Foundation Trust and Institute of Medical and Biomedical Science, St George’s University of London, London, UK; M. Toledo, Vall d’Hebron University Hospital, Autonomous University of Barcelona, Barcelona, Spain.

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Hoy, S.M. Brivaracetam: A Review in Partial-Onset (Focal) Seizures in Patients with Epilepsy. CNS Drugs 30, 761–772 (2016). https://doi.org/10.1007/s40263-016-0376-x

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