Abstract Details

Title Brivaracetam use in Hong Kong: a post-marketing cohort study

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P1 - Poster Session 1 (9:00 AM-5:00 PM)

Poster/Presentation
Number 140

Objective Not applicable

Background

BRV has been registered in Hong Kong since 2018. Our locality was one of the first Asian regions to grant the approval for epilepsy treatment. We reported the post-marketing use of BRV in Asian population.

Design/Methods

Epilepsy patients with BRV prescription between 2018 and 2021 were identified by computerized database. Psychiatric comorbidities and intellectual disability were defined by formal clinical diagnosis by clinicians. Terminology of epilepsy adhered to the ILAE’s definitions.

Results A total of 66 patients were recruited with equal sex proportions. DRE was 76%; intellectual disability 20%; focal epilepsy 76%; structural and unknown etiologies each accounted for 46%; psychiatric comorbidities 26%; with 76% switching from LEV. The mean age at commencing BRV was 39. Average number of concomitant ASM was 2. The median seizure frequency in the 12 weeks before BRV was 1/month, with 20% of them seizure-free. The median seizure frequency was 0/month after BRV. About 25% were seizure free (18% continued seizure freedom) 12 weeks after BRV use. Reasons for switching from LEV included emotional adverse effects from LEV (60%) and optimizing seizure control (38%). Vast majority (96%) had overnight switch. Eight patients (12%) stopped BRV (6 due to TEAEs: 3 malaise or drowsiness; 3, mood problems). Binomial regression analysis showed that switching from LEV was associated with lower risk of BRV intolerance (p=0.017) while other factors, including ages at diagnosis and BRV use, sex, concomitant ASM number and EIASM, psychiatric comorbidities, intellectual disability, epilepsy subtypes and etiologies, refractory epilepsy, had no effect.

Conclusions

BRV is in general well tolerated. Most clinical factors did not associate with BRV tolerability. Switching from LEV was a feasible practice. The main goals of replacing LEV by BRV are typified by better psychiatric profile and seizure control but these achievements need further verification by larger studies.

Authors/Disclosures
Wui Ho PRESENTER	Wui Ho has nothing to disclose.
Holy Chan	No disclosure on file
Sze Wai E. Yeung, MD (Pamela Youde Nethersole Eastern Hospital)	No disclosure on file
Hoi Ki, Kate Lui, MD (Tseung Kwan O Hospital)	Dr. Lui has nothing to disclose.
	No disclosure on file
Eric Lok Yiu Chan, MBBS, MRCP, FRCP	Dr. Chan has nothing to disclose.
Cheuk Nam Rachel Lo	No disclosure on file
Yun Hin Ian Leung	Yun Hin Ian Leung has nothing to disclose.
William C. Leung, MBBS, MRCP, FHKAM (A1 Office, Department of Medicine,)	Dr. Leung has nothing to disclose.
Chang Shek Kwan, MD	Dr. Kwan has nothing to disclose.

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