Francesco Brigo1,2, Simona Lattanzi3, Raffaele Nardone4,5, Eugen Trinka5,6. 1. Division of Neurology, "Franz Tappeiner" Hospital, Merano, Bolzano, Italy. dr.francescobrigo@gmail.com. 2. Department of Neuroscience, Biomedicine and Movement Science, University of Verona, Piazzale L.A. Scuro, 10, 37134, Verona, Italy. dr.francescobrigo@gmail.com. 3. Department of Experimental and Clinical Medicine, Neurological Clinic, Marche Polytechnic University, Ancona, Italy. 4. Division of Neurology, "Franz Tappeiner" Hospital, Merano, Bolzano, Italy. 5. Department of Neurology, Christian Doppler University Hospital, Paracelsus Medical University, Salzburg, Austria. 6. Institute of Public Health, Medical Decision Making and Health Technology Assessment, University for Health Sciences, Medical Informatics and Technology, UMIT, Hall in Tyrol, Austria.
Abstract
BACKGROUND: Brivaracetam is a high-affinity synaptic vesicle glycoprotein 2A ligand with high brain permeability and rapid onset of action. These properties make brivaracetam potentially an ideal compound in the emergency setting. OBJECTIVE: The objective of our study was to review the evidence about the clinical efficacy and tolerability of intravenous brivaracetam in the treatment of status epilepticus. METHODS: We systematically searched MEDLINE, EMBASE, Google Scholar, ClinicalTrials.gov, and conference proceedings to identify studies evaluating intravenous brivaracetam as treatment for status epilepticus of any type in patients of any age. Searches were conducted on 3 December, 2018. RESULTS: Seven studies were included (37 patients; aged 22-85 years; 21 were female). The type and etiology of status epilepticus varied across studies. The number of drugs used prior to brivaracetam to treat status epilepticus ranged from 1 to 8. The time from status epilepticus onset to brivaracetam administration ranged from 0.5 h to 105 days. The initial brivaracetam dose ranged from 50 to 400 mg. In case series, the proportion of patients achieving clinical status epilepticus cessation when brivaracetam was administered as the last drug varied from 27 to 50%; in case reports, all patients had status epilepticus cessation. The time from brivaracetam administration to status epilepticus cessation ranged from 15 min to 94 h. No serious adverse effects were reported. CONCLUSIONS: The available data suggested that brivaracetam can be a safe treatment option in patients with status epilepticus. The current evidence is however hampered by several confounding factors, and controlled studies are warranted to define the actual benefit of brivaracetam for the treatment of status epilepticus.
BACKGROUND:Brivaracetam is a high-affinity synaptic vesicle glycoprotein 2A ligand with high brain permeability and rapid onset of action. These properties make brivaracetam potentially an ideal compound in the emergency setting. OBJECTIVE: The objective of our study was to review the evidence about the clinical efficacy and tolerability of intravenous brivaracetam in the treatment of status epilepticus. METHODS: We systematically searched MEDLINE, EMBASE, Google Scholar, ClinicalTrials.gov, and conference proceedings to identify studies evaluating intravenous brivaracetam as treatment for status epilepticus of any type in patients of any age. Searches were conducted on 3 December, 2018. RESULTS: Seven studies were included (37 patients; aged 22-85 years; 21 were female). The type and etiology of status epilepticus varied across studies. The number of drugs used prior to brivaracetam to treat status epilepticus ranged from 1 to 8. The time from status epilepticus onset to brivaracetam administration ranged from 0.5 h to 105 days. The initial brivaracetam dose ranged from 50 to 400 mg. In case series, the proportion of patients achieving clinical status epilepticus cessation when brivaracetam was administered as the last drug varied from 27 to 50%; in case reports, all patients had status epilepticus cessation. The time from brivaracetam administration to status epilepticus cessation ranged from 15 min to 94 h. No serious adverse effects were reported. CONCLUSIONS: The available data suggested that brivaracetam can be a safe treatment option in patients with status epilepticus. The current evidence is however hampered by several confounding factors, and controlled studies are warranted to define the actual benefit of brivaracetam for the treatment of status epilepticus.
Authors: Eugen Trinka; Julia Höfler; Markus Leitinger; Alexandra Rohracher; Gudrun Kalss; Francesco Brigo Journal: Expert Opin Pharmacother Date: 2016-02-09 Impact factor: 3.889
Authors: Eugen Trinka; Hannah Cock; Dale Hesdorffer; Andrea O Rossetti; Ingrid E Scheffer; Shlomo Shinnar; Simon Shorvon; Daniel H Lowenstein Journal: Epilepsia Date: 2015-09-04 Impact factor: 5.864
Authors: Brian Hutton; Georgia Salanti; Deborah M Caldwell; Anna Chaimani; Christopher H Schmid; Chris Cameron; John P A Ioannidis; Sharon Straus; Kristian Thorlund; Jeroen P Jansen; Cynthia Mulrow; Ferrán Catalá-López; Peter C Gøtzsche; Kay Dickersin; Isabelle Boutron; Douglas G Altman; David Moher Journal: Ann Intern Med Date: 2015-06-02 Impact factor: 25.391
Authors: Elma M Paredes-Aragón; Héctor E Valdéz-Ruvalcaba; Andrea Santos-Peyret; Marcela Cisneros-Otero; Raúl Medina-Rioja; Sandra Orozco-Suárez; Miriam M Hernandez; Michele D L Breda-Yepes; Verónica Rivas-Alonso; José J Flores-Rivera; Iris E Martínez-Juárez Journal: Front Neurol Date: 2020-11-26 Impact factor: 4.003