Title : Seizure control across ages: A prospective observational study Ccomparing the efficacy and safety of brivaracetam and levetiracetam
Abstract:
Background: There are increasing incidences of psychiatric side effects resulting from the use of anti-epileptics. Prospective observational studies on the effectiveness and safety of levetiracetam (LEV) and brivaracetam (BRV), along with the haematological abnormalities of both treatments in seizure patients in an Indian population, are lacking. Therefore, we aimed to compare the effectiveness and safety of LEV and BRV in seizure patients.
Objectives: To compare the effectiveness in terms of seizure frequency and the safety in terms of behavioural and non-behavioural side effects, compare and assess the switch from LEV to BRV or vice versa in patients with seizure or epilepsy.
Methods: A prospective observational study of newly diagnosed as well as previously diagnosed patients (n = 115) with seizure or epilepsy aged ≥5 years of age receiving LEV (n = 66) or BRV (n = 49). Baseline data were collected during the initiation of the study and were compared to the data obtained at the end of the study. Seizure severity questionnaire was used to assess the severity of seizures, whereas a brief psychiatric rating scale, Hamilton anxiety rating scale, and pediatric epilepsy side effects questionnaire were used to assess and compare the behavioural and non-behavioural side effects associated with both treatments.
Results: At baseline, adults taking LEV showed a higher percentage of BAEs compared to adults taking BRV. Among all the three follow-up patients, the most common behavioural adverse event reported in both groups of patients taking LEV and BRV was depression. Significant results with drowsiness were the highest reported non-behavioural side effects in patients taking BRV. Patients who switched from LEV to BRV due to psychiatric side effects showed positive results with BRV (n = 5).
Conclusion: In summary, the study found that BRV is a safe option for treating seizures, resulting in fewer and less severe side effects compared to LEV in epileptic patients. While LEV showed slightly higher efficacy and a lower drowsiness probability, BRV proved more tolerable for those with LEV-induced side effects. Switching from LEV to BRV decreased the psychiatric side effects.
