Levetiracetam and Brivaracetam: a Review of Evidence from Clinical Trials and Clinical Experience

Overview

Journal Ther Adv Neurol Disord

Specialty Neurology

Date 2019 Sep 17

PMID 31523280

Citations 28

Authors

Bernhard J Steinhoff

Anke M Staack

Affiliations

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Abstract

Until the early 1990s, a limited number of antiepileptic drugs (AEDs) were available. Since then, a large variety of new AEDs have been developed and introduced, several of them offering new modes of action. One of these new AED families is described and reviewed in this article. Levetiracetam (LEV) and brivaracetam (BRV) are pyrrolidone derivate compounds binding at the presynaptic SV2A receptor site and are thus representative of AEDs with a unique mode of action. LEV was extensively investigated in randomized controlled trials and has a very promising efficacy both in focal and generalized epilepsies. Its pharmacokinetic profile is favorable and LEV does not undergo clinically relevant interactions. Adverse reactions comprise mainly asthenia, somnolence, and behavioral symptoms. It has now been established as a first-line antiepileptic drug. BRV has been recently introduced as an adjunct antiepileptic drug in focal epilepsy with a similarly promising pharmacokinetic profile and possibly increased tolerability concerning psychiatric adverse events. This review summarizes the essential preclinical and clinical data of LEV and BRV that is currently available and includes the experiences at a large tertiary referral epilepsy center.

Citing Articles

Current Role of Brivaracetam in the Management of Epilepsy in Adults and Children: A Systematic Review.

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A multicenter, cross-sectional analysis to assess the safety and usage pattern of brivaracetam in the management of partial-onset seizure with BAEs-BREEZE study: A post-hoc analysis.

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BRIVA-ONE study: 12-month outcomes of brivaracetam monotherapy in clinical practice.

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A single exposure to brivaracetam or perampanel does not cause cell death in neonatal rats.

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Oligoprotective Activity of Levetiracetam against Glutamate Toxicity: An Study.

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