Abstract Details

Title Long-term Retention on Adjunctive Brivaracetam in Adults With Focal Seizures Previously Exposed to Carbamazepine, Lamotrigine, Levetiracetam, or Topiramate: A Post Hoc Analysis

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P5 - Poster Session 5 (5:30 PM-6:30 PM)

Poster/Presentation
Number 6-012

Objective

To explore the long-term effectiveness of adjunctive brivaracetam (BRV) in patients with focal seizures previously treated with carbamazepine (CBZ), lamotrigine (LTG), levetiracetam (LEV), or topiramate (TPM).

Background

Previous post hoc analysis of three 12-week, double-blind, placebo-controlled trials of adjunctive BRV in patients with focal seizures demonstrated similar and significant efficacy of BRV over placebo regardless of previous CBZ, LTG, LEV, or TPM treatment failure.

Design/Methods Post hoc analysis of double-blind, placebo-controlled trial (N01358; NCT01261325) and corresponding open-label extension (N01379 [NCT01339559]; cut-off 15 March 2017) of adjunctive BRV in patients (≥16 years) with focal seizures randomized to BRV 100 or 200 mg/day (pooled) in the initial double-blind trial. Outcomes were assessed in subgroups of patients who had tried CBZ, LTG, LEV, or TPM and stopped at least 90 days prior to BRV initiation.

Results 503 patients were randomized to BRV 100 or 200 mg/day. Baseline demographics and epilepsy characteristics were similar in subgroups previously treated with CBZ (n=209), LTG (n=162), LEV (n=256), or TPM (n=182). Overall, the estimated BRV retention (Kaplan-Meier [KM] analysis) was 71.0%, 50.9%, and 32.4% at 1, 3, and 5 years. KM-estimated retention rates on adjunctive BRV were generally similar across previous antiepileptic drug (AED) subgroups (64.8%–73.2% at 1 year; 41.9%–49.9% at 3 years; 31.5%–35.7% at 5 years). Similar proportions of patients discontinued BRV irrespective of previous AED (CBZ 58.4%; LTG 63.0%; LEV 58.6%; TPM 60.4%). The most frequent reasons for BRV discontinuation were similar between subgroups (most commonly: lack of efficacy 23.0%–25.3%, and adverse event 16.7%–22.2%).

Conclusions This post hoc analysis demonstrated similar long-term retention rates and discontinuation reasons with adjunctive BRV in adults with focal seizures previously treated with CBZ, LTG, LEV, or TPM. Adjunctive BRV provides long-term effectiveness in patients who failed common AED treatments, including LEV.

Authors/Disclosures
Steve Chung, MD, FAAN (Banner University Medical Center) PRESENTER	The institution of Dr. Chung has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for ucb pharma. Dr. Chung has received personal compensation in the range of $500-$4,999 for serving as a Consultant for SK Life sciences. Dr. Chung has received personal compensation in the range of $500-$4,999 for serving as a Consultant for eisai. Dr. Chung has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for eisai. Dr. Chung has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for ucb. Dr. Chung has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for SK Life sciences. Dr. Chung has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for sunovion.
Melinda S. Martin, PhD	Dr. Martin has received personal compensation for serving as an employee of UCB. Dr. Martin has received stock or an ownership interest from UCB.
	No disclosure on file
	No disclosure on file
Cedric Laloyaux, PhD (UCBMedical Affairs Center of Expertise)	Dr. Laloyaux has received personal compensation for serving as an employee of UCB.

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