Effectiveness and Safety of Brivaracetam in Children, Finds
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The Study proposed that Brivaracetam adjunctive treatment was well tolerated, safe, and effective in children. More than 25% of children with seizures suffer from refractory epilepsy. Brivaracetam is an antiepileptic drug (AED) approved by the United States Food and Drug Administration (USFDA) and indicated in patients older than 4 years. This retrospective study evaluated the efficacy and safety of Brivaracetam in children with refractory epilepsy below 18 years of age.

Analysis was done on total 38 patients, of which 25 were males with Mean age of 5.9 years. Various epilepsy syndromes were West syndrome; Lennox–Gastaut syndrome (LGS); Dravet syndrome; and tuberous sclerosis (TS). The average dose of Brivaracetam used was 2 mg/kg/body weight.

Results:
--Decrease in seizure frequency was more than 50% in 14/38 with 4 of them seizure-free, no change in 18, & less than 50% showed worsening of seizures.

--More than 50% reduction noted in West syndrome (3), LGS (5), TS (2). Seizure-free in 3 cases of unknown etiology and 1 case of West syndrome.

--11 of them had more than 50% seizure reduction in Levetiracetam (LEV) switch cases. The adverse effects were drowsiness and mood swings in 1 child each.

--2/4 patients reported improvement in behavior in LEV switch cases. The duration of follow-up was 12 months, and during this period, no change in effectiveness was noted in those who responded.

Brivaracetam has 15- to 30-fold high affinity for synaptic vesicle 2A than LEV. It has high lipid solubility, rapid brain penetration, and broad-spectrum antiepileptic activity. The safety and tolerability profile in children are similar to adults.

Researchers noted greater than 50% seizure reduction in 36% patients, seizure-free in 10%, unchanged seizure frequency in 47%, increased seizure frequency in 5.2% compared to 44%, 17%, 38%, and 18%, respectively reported in adults. It was concluded that Brivaracetam adjunctive treatment was well tolerated, safe, and effective in children.

Source: https://link.springer.com/article/10.1007/s12098-021-03697-6
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