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Year : 2021  |  Volume : 69  |  Issue : 2  |  Page : 284--293

Brivaracetam: How Well Does It Fare as an Anti-Epileptic? A Review

1 Consultant Neurologist, Apollo Health City, Jubilee Hills, Hyderabad, Telangana, India
2 Department of Neurology, JIPMER, Puducherry, India
3 Lead – Scientific writing, Indegene Pvt Ltd., Nagwara, Bangalore, India

Correspondence Address:
Dr. Madhuri Khilari
Consultant Neurologist, Apollo Health City, Jubilee Hills, Hyderabad, Telangana
Dr. Pradeep P Nair
HOD, Department of Neurology, JIPMER, Super-Specialty Block, Pondicherry - 605 006
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0028-3886.314584

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Objectives: Epilepsy is a common neurological ailment contributing to significant disability. About one-third of all epilepsy patients would be refractory to two or more medications. Brivaracetam (BRV) is one of the newer anti-seizure medications on which extensive data is available, but its efficacy as an early add-on agent (first/second adjuvant) is unclear. The principal objective of this review is to assess the efficacy of BRV as an early add-on agent in refractory Focal Onset Seizures (FOS) and its pharmacology and usage in various clinical situations associated with seizures. Methods: We searched two databases, Medline and Cochrane Central, for papers on BRV and FOS, and selected six studies with randomized parallel control design to extract the data for a meta-analysis. We also did a comprehensive review of the available literature on its pharmacology and usage in various clinical scenarios associated with seizures. Results: For the meta-analysis, we extracted 145 articles; six studies fulfilled the selection criteria that gave us data on 1938 patients who received Brivaracetam as an early add-on agent in FOS. The Risk Ratio (RR) (95% CI) for 50% responders across the trials was 1.88 (1.55–2.29). Similarly, the overall RR (95% CI) was 5.82 (2.15–15.70) for seizure freedom. Conclusion: Our analysis provides moderate evidence for Brivaracetam as an effective agent as an early adjuvant in FOS. Its efficacy for several other indications needs further clinical trials and evaluation.


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