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Evidence summaries

Brivaracetam Addon Therapy for Drugresistant Epilepsy

Brivaracetam as an add-on therapy for adults with drug-resistant focal epilepsy is effective in reducing seizure frequency and achieving seizure freedom. However, it is associated with a greater proportion of treatment withdrawals due to adverse events. Level of evidence: "A"

Summary

A Cochrane review [Abstract] 1 included 6 studies with a total of 2411 patients. Five trials included patients with focal onset seizures only. All 6 studies included adults, and treatment periods ranged from 7 to 16 weeks. Patients receiving brivaracetam add-on were significantly more likely to experience a 50% or greater reduction in seizure frequency than those receiving placebo (RR 1.81, 95% CI 1.53 to 2.14; 6 studies; n=2411). They were also significantly more likely to attain seizure freedom (RR 5.89, 95% CI 2.30 to 15.13; 6 studies; n=2411). The incidence of treatment withdrawal for any reason (RR 1.27, 95% CI 0.94 to 1.74; 6 studies; n=2411), as well as the risk of one or more adverse events (RR 1.08, 95% CI 1.00 to 1.17; 5 studies; n=2011) was not significantly different as compared to placebo. However, patients receiving brivaracetam withdrew from treatment significantly more because of adverse events (RR 1.54, 95% CI 1.02 to 2.33; 6 studies; n=2411).

Clinical comments

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