Potential role of brivaracetam in pediatric epilepsy

Verrotti, Alberto; Grasso, E; Cacciatore, Marta; Matricardi, Sara; Striano, Pasquale

doi:10.1111/ane.13347

Cited by 16 publications

(11 citation statements)

References 40 publications

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“…Brivaracetam has been approved as adjunctive treatment in adults and pediatric patients aged 4 years and older with focal onset seizures. It seems to show a positive response also in patients affected by some encephalopathic epilepsies ( Tulli et al, 2021 ; Verrotti et al, 2021 ). Another emergent promising ASM is Cannabidiol (CBD).…”

Section: Introductionmentioning

confidence: 96%

Improving Therapy of Pharmacoresistant Epilepsies: The Role of Fenfluramine

et al. 2022

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Epilepsy is among the most common neurological chronic disorders, with a prevalence of 0.5–1%. Despite the introduction of new antiepileptic drugs during recent years, about one third of the epileptic population remain drug-resistant. Hence, especially in the pediatric population limited by different pharmacokinetics and pharmacodynamics and by ethical and regulatory issues it is needed to identify new therapeutic resources. New molecules initially used with other therapeutic indications, such as fenfluramine, are being considered for the treatment of pharmacoresistant epilepsies, including Dravet Syndrome (DS) and Lennox-Gastaut Syndrome (LGS). Drug-refractory seizures are a hallmark of both these conditions and their treatment remains a major challenge. Fenfluramine is an amphetamine derivative that was previously approved as a weight loss drug and later withdrawn when major cardiac adverse events were reported. However, a new role of fenfluramine has emerged in recent years. Indeed, fenfluramine has proved to be a promising antiepileptic drug with a favorable risk–benefit profile for the treatment of DS, LGS and possibly other drug-resistant epileptic syndromes. The mechanism by which fenfluramine provide an antiepileptic action is not fully understood but it seems to go beyond its pro-serotoninergic activity. This review aims to provide a comprehensive analysis of the literature, including ongoing trials, regarding the efficacy and safety of fenfluramine as adjunctive treatment of pharmacoresistant epilepsies.

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Section: Introductionmentioning

confidence: 96%

Improving Therapy of Pharmacoresistant Epilepsies: The Role of Fenfluramine

et al. 2022

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“…Further studies are needed to draw definitive conclusions about its efficacy in non-LEV-naive participants and evaluate its long-term safety profile ( 87 ). Increasing evidence also supports its prescription to pediatric patients thanks to its efficacy and tolerability profile ( 88 ).…”

Section: Pharmacological Therapy In Drug-resistant Epilepsymentioning

confidence: 99%

The Pharmacoresistant Epilepsy: An Overview on Existent and New Emerging Therapies

et al. 2021

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Epilepsy is one of the most common neurological chronic disorders, with an estimated prevalence of 0. 5 – 1%. Currently, treatment options for epilepsy are predominantly based on the administration of symptomatic therapy. Most patients are able to achieve seizure freedom by the first two appropriate drug trials. Thus, patients who cannot reach a satisfactory response after that are defined as pharmacoresistant. However, despite the availability of more than 20 antiseizure medications (ASMs), about one-third of epilepsies remain drug-resistant. The heterogeneity of seizures and epilepsies, the coexistence of comorbidities, and the broad spectrum of efficacy, safety, and tolerability related to the ASMs, make the management of these patients actually challenging. In this review, we analyze the most relevant clinical and pathogenetic issues related to drug-resistant epilepsy, and then we discuss the current evidence about the use of available ASMs and the alternative non-pharmacological approaches.

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“…Behandlungen mit Valproat, Lamotrigin, Rufinamid (orphan drug), Clobazam, Felbamat und Topiramat haben sich bewährt. Auch Levetirazetam, Zonisamid, Perempanel und Brivarazetam (off-label) wurden als wirksam bewertet (Review siehe [34,35]). Es liegen allerdings keine allgemeinen Therapieleitlinien vor.…”

Section: Therapieunclassified

Pädiatrische epileptische Enzephalopathien mit Manifestation oberhalb des Neugeborenenalters: ein Up-date

Trollmann

Borggräfe

Müller‐Felber

et al. 2021

Klinische Neurophysiologie

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ZusammenfassungEntwicklungs-und epileptische Enzephalopathien manifestieren sich überwiegend bereits im Säuglings-und frühen Kleinkindesalter. Mit der neuen ILAE-Klassifikation der Epilepsien konnten epileptische Enzephalopathien sowohl hinsichtlich des elektroklinischen Phänotyps als auch des ätiologischen Spektrums und assoziierter Komorbiditäten genauer definiert werden. Einige elektroklinischer Entitäten wie das West-Syndrom oder das Dravet-Syndrom können auf der Basis ihres Genotyps inzwischen als spezifische Enzephalopathien klassifiziert werden. Das EEG stellt eine wichtige Zusatzdiagnostik in der Abklärung einer epileptischen Enzephalopathie dar. Es hat einen besonderen Stellenwert für die Diagnose von Komplikationen wie z. B. subklinischer Anfälle oder eines Status epilepticus sowie für ein adäquates Therapiemonitoring. Der Betrag fasst anhand ausgewählter pädiatrischer Epilepsiesyndrome aktuelle Aspekte zur Komplexität der pädiatrischen epileptischen Enzephalopathien und den Stellenwert der EEG-Diagnostik zusammen.

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Potential role of brivaracetam in pediatric epilepsy

Cited by 16 publications

References 40 publications

Improving Therapy of Pharmacoresistant Epilepsies: The Role of Fenfluramine

Improving Therapy of Pharmacoresistant Epilepsies: The Role of Fenfluramine

The Pharmacoresistant Epilepsy: An Overview on Existent and New Emerging Therapies

Pädiatrische epileptische Enzephalopathien mit Manifestation oberhalb des Neugeborenenalters: ein Up-date

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