Efficacy of levetiracetam in children with refractory epilepsy as an add-on trial

Tonekaboni, Seyed Hassan; Ghazavi, Mohammadreza; Karimzadeh, Parvaneh; Mahvelati, F.; Ghofrani, Mohammad

doi:10.1016/j.eplepsyres.2010.06.002

Cited by 9 publications

(6 citation statements)

References 19 publications

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“…One out of every 4-5 children or adults with drug-resistant epilepsy is likely to respond to the adjunctive treatment with LEV [17]. Table 2 summarizes the open-label, prospective and retrospective studies of LEV in refractory epilepsy of various types [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35]. The results in terms of responder rates, complete seizure freedom, and the retention rates demonstrate large heterogeneity, which is a reflection of heterogeneity of the prognosis, depending upon seizure types, number of concomitant AEDs, presence or absence of encephalopathies, and idiopathic or symptomatic etiologies.…”

Section: Adjunctive Therapy In Refractory Partial Epilepsymentioning

confidence: 99%

“…The responder rates in open-label studies enrolling children with all seizure types were in the range of 30-61% (Table 2) [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35]. Some outliers in terms of responder rates were 74% and 25% [29,32].…”

Section: Adjunctive Therapy In Refractory Epilepsy (Partial Generalimentioning

confidence: 99%

“…The rates of behavioral AEs reported in trials in the pediatric population are between 6% and 33% [21][22][23][24][25][28][29][30][32][33][34]. A cochrane review states that be-havioral AEs related to LEV have been negligible in adults (1%) but significantly higher in children (23%) [17].…”

Section: Behavioral and Other Neuropsychological Changesmentioning

confidence: 99%

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Levetiracetam: Pharmacological properties, safety and efficacy in the pediatric population with epilepsy

Ansari

2015

J Pediatr Neurol

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Age-specific distribution of epilepsy is bimodal, with the highest incidence being in childhood. Seizures can affect life as early as day one. There is a paramount variation of epilepsy in childhood and adolesence with regards to its etiology and prognosis. Antiepileptic drugs, being the mainstay of treatment, necessitates that their use in this vulnerable age group must be made after a thorough look into the available evidence. The data on levetiracetam (LEV), a second-generation antiepileptic, spans from randomized controlled trials to case reports in various pediatric epilepsy and epileptic syndromes. This review is a compilation and critical analysis of the data on the differences in the pharmacokinetic properties of LEV in children versus adults, drug-interactions, efficacy of LEV in various contexts, namely, as add-on, as monotherapy, in partial and generalized seizures, in specific epilepsy syndromes such as benign epilepsy with centrotemporal spikes, epileptic syndromes with continuous spike and wave during sleep, Lennox-Gastaut syndrome, Jeavons syndrome and epilepsy associated with tuberous sclerosis. LEV is an effective option for the treatment of partial-onset seizures as both an add-on in refractory epilepsy and monotherapy in newly diagnosed focal epilepsies. There are preliminary but promising data available on various epileptic syndromes and epileptic encephalopathies that can nudge researchers towards further work in these areas in order to generate evidences that is more substantial. The safety and tolerability profile of LEV is favorable, though, behavioral and neuropsychiatric adverse events are reportedly higher in children versus adults. The neuropsychiatric adverse events are often observed against the background of previously existing behavioral issues and neurocognitive impairments.

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Section: Adjunctive Therapy In Refractory Partial Epilepsymentioning

confidence: 99%

Section: Adjunctive Therapy In Refractory Epilepsy (Partial Generalimentioning

confidence: 99%

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Levetiracetam: Pharmacological properties, safety and efficacy in the pediatric population with epilepsy

Ansari

2015

J Pediatr Neurol

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“…Levetiracetam je efikasan i siguran lek, što su po kazali i rezultati našeg istraživanja [9,10]. Poboljšanje koje je zapaženo posle uvođenja levetiracetama kod više od polovine bolesnika smatra se povoljnim, s obzirom da su svi bolesnici koji su uključeni u studiju imali farmako rezistentnu epilepsiju i da je levetiracetam primenjivan kao treći, četvrti ili peti antiepilpetički lek.…”

Section: Diskusijaunclassified

Efikasnost u lecenju i nezeljeni efekti levetiracetama kod dece sa epilepsijom

Obradovic¹,

Novkovic²

2014

Med podmladak

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Zaključak: Levetiracetam se pokazao kao siguran i efikasan lek kod više od polovine bolesnika sa farmako rezistentnom epilepsijom, naročito u epilepsijama koje su uzrokovane perinatalnom asfiksijom i metaboličkim poremećajima. Uvod: Levetiracetam je noviji antiepileptički lek koji zahvaljujući svom dejstvu na kontrolu napada i do broj podnošljivosti zauzima značajno mesto u kliničkoj praksi poslednjih desetak godina. Cilj: Cilj rada je procena efikasnosti levetira cetama u kontroli epileptičnih napada i procena njegovih neželjenih efekata u pedijatrijskoj populaciji. Materijal i metode: Retrospektivno istraživa nje je obuhvatilo 60 bolesnika uzrasta od jednog mese ca do 17 godina. Analiziran je uticaj pola, uzrasta, tipa epileptičnog napada i etiologije epilepsije na efekat leka i beleženi su neželjeni efekti. Efikasnost leka je proce njivana na osnovu broja napada u šestomesečnom perio du pre i nakon uvođenja leka. Lek je ocenjen kao efikasan ako bi došlo do redukcije broja napada za više od 50% u odnosu na broj napada pre primene istog. Lek je prime njivan u dozi od 3060 mg/kg, a maksimalna dnevna doza iznosila je 3 g dnevno. Rezultati: Levetiracetam je pokazao efikasnost kod 58,33% bolesnika. Razlika u efikasnosti leka među polovima je bila statistički značajna (p < 0,05). Pokazao se kao efikasan kod 60% pacijenata sa fokalnim i 56,71% sa generalizovanim tipom napada. Najefikasniji je bio kod epileptičnih napada uzrokovanih metaboličkim obo ljenjima i perinatalnom asfiksijom, a manje efikasan kod dece sa malformacijama kortikalnog razvoja i ova ra z lika je statistički značajna (p = 0,027). Neželjeni efekti su zapaženi kod četiri bolesnika.

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“…[23] We have retrospectively studied the efficacy and tolerability of add-on LEV in our children with refractory epilepsy during 6 month treatment.…”

Section: Introductionmentioning

confidence: 99%

The efficacy and side effects of levetiracetam on refractory epilepsy in children

2012

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Objective:To evaluate the efficacy and tolerability of levetiracetam (LEV) add-on therapy in children with refractory epilepsy.Materials and Methods:We evaluated 102 children (56 boys, 46 girls, mean age 96.00 ± 31.15 months) with refractory epilepsy. Patients received LEV as add-on therapy. Changes in seizure frequency and adverse events were observed. Follow-up was conducted at least 6 months after treatment.Results:In total, 46 (45.1%) of the 102 children achieved more than 50% seizure frequency reduction, and 16 (15.6%) of these were seizure free. LEV reduced seizure frequency by at least 50% in 58.3% of patients with partial seizures, in 32.0% of patients with primary generalized seizures, and in 17.6% of patients with both partial and generalized seizures.Conclusion:Our results confirm that LEV, as add-on therapy, was effective in reducing seizure frequency in a variety of seizure types but seems most effective for partial-onset seizures. LEV was also well-tolerated in children.

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Efficacy of levetiracetam in children with refractory epilepsy as an add-on trial

Cited by 9 publications

References 19 publications

Levetiracetam: Pharmacological properties, safety and efficacy in the pediatric population with epilepsy

Levetiracetam: Pharmacological properties, safety and efficacy in the pediatric population with epilepsy

Efikasnost u lecenju i nezeljeni efekti levetiracetama kod dece sa epilepsijom

The efficacy and side effects of levetiracetam on refractory epilepsy in children

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