Hostname: page-component-84b7d79bbc-fnpn6 Total loading time: 0 Render date: 2024-07-26T13:50:00.318Z Has data issue: false hasContentIssue false
  • English
  • Français

Levetiracetam in Clinical Practice: Efficacy and Tolerability in Epilepsy

Published online by Cambridge University Press:  02 December 2014

Leonilda Bilo ,
Maria Fulvia de Leva  and
Roberta Meo
Leonilda Bilo*
Affiliation:
Epilepsy Center, Department of Neurological Sciences, “Federico II” University
Maria Fulvia de Leva
Affiliation:
Epilepsy Center, Department of Neurological Sciences, “Federico II” University
Roberta Meo
Affiliation:
Neurology Outpatient Service, Azienda Sanitaria Locale Napoli 1, Naples, Italy
*
Via Santo Stefano 12/b, 80127 Napoli, Italy.
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Background:

The aim of this study was to evaluate efficacy and tolerability of levetiracetam (LEV) in patients with different epilepsy syndromes.

Methods:

We evaluated epileptic patients seen in the previous 18 months, including all patients with present or past exposure to LEV. Tolerability of LEV therapy was evaluated in all patients; efficacy was evaluated only in patients who had received LEV for at least six months. Two hundred and two patients were included in the study. Patients were considered responsive when showing a > 50% reduction in seizures frequency and non-responders when seizure frequency was unchanged, worsened or showed a reduction < 50%.

Results:

Thirty patients did not complete six months of LEV treatment and dropped out. 57.4% of the patients with uncontrolled seizures treated for at least six months were responders, with 27.7% seizure free. Adverse effects were observed in 46 patients (23%) and were responsible for early drop out in 26. Adverse effects occurred significantly more often in females than in males (30.6% vs 13.2%); moreover, nearly 30% of women with adverse effects complained of more than one adverse effect, while this was never observed in male patients.

Conclusions:

Our study shows LEV as a well tolerated and effective treatment, both in monotherapy and as an add-on. Further investigations on larges samples are needed to investigate the issue of gender-related tolerability.

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 37 , Issue 3 , May 2010 , pp. 376 - 382
Copyright
Copyright © The Canadian Journal of Neurological 2010

References

1. Cereghino, JJ, Biton, V, Abou-Khalil, B, Dreifuss, F, Gauer, LJ, Leppik, I. Levetiracetam for partial seizures: results of a double-blind, randomized clinical trial. Neurology. 2000; 55: 236–42.CrossRefGoogle ScholarPubMed
2. Shorvon, SD, Lowenthal, A, Janz, D, Bielen, E, Loiseau, P. Multicenter double-blind, randomized, placebo controlled trial of levetiracetam as add-on therapy in patients with refractory partial seizures. European Levetiracetam Study Group. Epilepsia. 2000; 41: 1179–86.CrossRefGoogle ScholarPubMed
3. Nicolson, A, Lewis, SA, Smith, DF. A prospective analysis of the outcome of levetiracetam in clinical practice. Neurology. 2004; 63: 568–70.CrossRefGoogle ScholarPubMed
4. Kinirons, P, McCarthy, M, Doherty, CP, Delanty, N. Predicting drug-resistant patients who respond to add-on therapy with levetiracetam. Seizure. 2006; 15: 387–92.CrossRefGoogle ScholarPubMed
5. Bootsma, HP, Ricker, L, Diepman, L, Gehring, J, Hulsman, J, Lambrechts, D, et al. Levetiracetam in clinical practice: long term experience in patients with refractory epilepsy referred to a tertiary epilepsy center. Epil Behavior. 2007; 10: 296–303.CrossRefGoogle ScholarPubMed
6. Alsaadi, TM, Shatzel, A, Marquez, AV, Jorgensen, J, Farias, S. Clinical experience of levetiracetam monotherapy for adults with epilepsy: 1-year follow-up study. Seizure. 2005; 14: 139–42.CrossRefGoogle ScholarPubMed
7. Sharpe, DV, Patel, AD, Abou-Khalil, B, Fenichel, GM. Levetiracetam monotherapy in juvenile myoclonic epilepsy. Seizure. 2008; 17 (1): 64–8.CrossRefGoogle ScholarPubMed
8. Bilo, L, Meo, R, de Leva, MF, De Simone, R, Di Nocera, P, Pisani, F, et al. Levetiracetam in patients with epilepsy and chronic liver disease: observations in a case series. Clin Neuropharmacol. 2008; 31 (4): 221–5.CrossRefGoogle ScholarPubMed
9. Bilo, L, Meo, R, de Leva, MF. Levetiracetam in idiopathic generalized epilepsy and porphyria cutanea tarda. Clin Drug Invest. 2006; 26 (6): 357–9.CrossRefGoogle Scholar
10. White, GR, Walczak, TS, Leppik, IE, Rarick, J, Tran, T, Beniack, TE, et al. Discontinuation of levetiracetam because of behavioral side effects: a case-control study. Neurology. 2003; 61 (9): 1218–21.CrossRefGoogle ScholarPubMed
11. Villanueva, V, Gomez-Caigova, A, Gutierrez-Delicado, E, Serratosa, JM. Open label, prospective and observational study of efficacy and tolerability with levetiracetam during one year of follow-up. Neurologia. 2007; 22 (6): 348–53.Google ScholarPubMed