Abstract Details

Title Effectiveness and Tolerability of Brivaracetam by Number of Lifetime Antiseizure Medications in Adults with Focal Onset Seizures: Pooled Data From Two Real-world Studies

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P11 - Poster Session 11 (11:45 AM-12:45 PM)

Poster/Presentation
Number 9-010

Objective Analyze impact of number of lifetime antiseizure medications (ASMs) on effectiveness and tolerability of brivaracetam (BRV) in adults with focal-onset seizures in a real-world clinical setting.

Background Increasing number of lifetime ASMs is associated with poorer response to newly administered ASM.

Design/Methods

Pooled analysis of data from two 12-month, prospective, noninterventional studies (Europe: EP0077/NCT02687711; United States: EP0088) in patients initiating BRV as prescribed by their physician and followed for ≤12 months. Post hoc analysis included patients (≥18 years) with focal-onset seizures and ≥1 lifetime ASM at BRV initiation. Outcomes were assessed by number of lifetime ASMs (ASMs stopped before BRV initiation/ongoing at BRV initiation).

Results Of 720 included patients, 14.0%, 22.9%, 16.5%, and 46.5% had 1–2, 3–4, 5–6, and ≥7 lifetime ASMs, respectively. Across ASM subgroups, main reason for BRV initiation was lack of efficacy of current treatment (range: 73.3% [1–2 ASMs] to 89.0% [≥7 ASMs]). In patients with 1–2, 3–4, 5–6, and ≥7 lifetime ASMs, respectively, 12-month BRV retention was 68.3%, 66.1%, 55.5%, and 51.3%; 20.0%, 14.8%, 6.8%, and 2.7% had 12-month seizure freedom since baseline. Patients with 1–2 and 3–4 lifetime ASMs were less likely to discontinue BRV/terminate the study vs those with ≥5 lifetime ASMs. A lower proportion of patients with fewer lifetime ASMs discontinued BRV due to lack of efficacy (range: 1.0% [1–2 ASMs] to 14.9% [≥7 ASMs]) or treatment-emergent adverse events (TEAEs, 5.0% [1–2 ASMs] to 15.2% [≥7 ASMs]). In patients with 1–2, 3–4, 5–6, and ≥7 lifetime ASMs, respectively, TEAEs were reported in 26.7%, 37.0%, 46.2%, and 50.4%; 13.9%, 17.0%, 21.8%, and 30.1% discontinued due to TEAEs.

Conclusions

Patients with fewer lifetime ASMs upon BRV initiation had numerically higher retention, and numerically lower incidences of TEAEs/discontinuations due to TEAEs.

Authors/Disclosures
Mallory Alonso, PharmD (UCB, Inc.) PRESENTER	Dr. Alonso has received personal compensation for serving as an employee of UCB, Inc.. Dr. Alonso has stock in UCB, Inc..
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.
Dimitrios Bourikas (UCB)	Dr. Bourikas has nothing to disclose.
	No disclosure on file
Prashant Dongre, MD, MBBS (UCB Inc)	Dr. Dongre has received personal compensation for serving as an employee of UCB Inc. Dr. Dongre has stock in UCB Inc.
	No disclosure on file
Iryna Leunikava	No disclosure on file
Allison Little, PharmD (UCB, Inc)	Dr. Little has received personal compensation for serving as an employee of Rapport Therapeutics.
Anne-Liv Schulz	No disclosure on file

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