Product information and disease description Place of product in therapy Approaches to treatment Current treatment options and standard of care

SV2A ligands

8 evidence topics · 8 sources

Levetiracetam as a first-line monotherapy option

“The committee agreed that lamotrigine and levetiracetam should be considered as first-line monotherapy options, and this was supported by economic modelling.” (opens the source at this quote in a new tab)

Mechanistic basis of the SV2A ligand class

“Of them, levetiracetam and brivaracetam show a high affinity to the synaptic vesicle protein type 2 A (SV2A), whereas pregabalin and gabapentin are selective ligands for the α2δ1 subunits of the voltage-gated calcium channels.” (opens the source at this quote in a new tab)

Adjunctive levetiracetam: pooled efficacy and dose response

“RR was significantly in favour of levetiracetam compared to placebo when results were pooled across all doses (RR 2.37, 95% CI 2.02 to 2.78; 14 studies, 2455 participants; moderate-certainty evidence).” (opens the source at this quote in a new tab)
“Dose–response analysis demonstrated that the odds of achieving response (50% or greater reduction in seizure frequency) were increased by nearly 40% (odds ratio (OR) 1.39, 95% CI 1.23 to 1.58) for each 1000 mg increase in dose of levetiracetam.” (opens the source at this quote in a new tab)

Adjunctive levetiracetam: pivotal placebo-controlled trial

“Of 199 patients receiving levetiracetam, 11 became seizure free; no patient became seizure free in the placebo group.” (opens the source at this quote in a new tab)

Adjunctive levetiracetam: European multicentre trial

“A reduction in seizure frequency of > or =50% occurred in 22.8% of patients in the 1,000-mg group and 31.6% of patients in the 2,000-mg group, compared with 10.4% of patients in the placebo group.” (opens the source at this quote in a new tab)

Adjunctive brivaracetam: pooled efficacy and withdrawal

“Participants receiving brivaracetam add-on were more likely to experience a 50% or greater reduction in seizure frequency than those receiving placebo (RR 1.81, 95% CI 1.53 to 2.14; 6 studies; moderate-certainty evidence).” (opens the source at this quote in a new tab)
“Participants receiving brivaracetam were more likely to attain seizure freedom; however, the evidence is of low certainty (RR 5.89, 95% CI 2.30 to 15.13; 6 studies).” (opens the source at this quote in a new tab)
“However, participants receiving brivaracetam did appear to be more likely to withdraw from treatment due to adverse events compared with those receiving placebo (RR 1.54, 95% CI 1.02 to 2.33; 6 studies; low-certainty evidence).” (opens the source at this quote in a new tab)

Adjunctive brivaracetam: phase 3 trial

“Percent reduction over PBO in 28-day adjusted seizure frequency (95% confidence interval [CI]) was 22.8% for BRV 100 mg/day (13.3-31.2%; p < 0.001) and 23.2% for BRV 200 mg/day (13.8-31.6%; p < 0.001).” (opens the source at this quote in a new tab)
“The ≥ 50% responder rate (odds ratio vs. PBO; 95% CI) was 21.6% for PBO, 38.9% for BRV 100 mg/day (2.39; 1.6-3.6; p < 0.001), and 37.8% for BRV 200 mg/day (2.19; 1.5-3.3; p < 0.001).” (opens the source at this quote in a new tab)

Adjunctive brivaracetam: pooled phase 3 analysis

“The ≥50% responder rate was 34.2% (50 mg/d, p = 0.0015), 39.5% (100 mg/d, p < 0.00001), and 37.8% (200 mg/d, p = 0.00003) vs 20.3% for placebo (p < 0.01).” (opens the source at this quote in a new tab)
“TEAEs in ≥5% patients taking BRV (vs placebo) were somnolence (15.2% vs 8.5%), dizziness (11.2% vs 7.2%), headache (9.6% vs 10.2%), and fatigue (8.7% vs 3.7%).” (opens the source at this quote in a new tab)