Levetiracetam & Seniors
A study presented at the 55th annual meeting of the American Epilepsy Society (in Philadelphia in December 2001) reveals new data which demonstrate the efficacy of levetiracetam (Keppraâ) as an add-on therapy to treat refractory epilepsy in seniors. The incidence and prevalence of epilepsy among seniors appears to be rising.
Conducted by Guenter Kramer, MD (Medical Director of the Swiss Epilepsy Centre), the study evaluated efficacy and tolerability of levetiracetam administered to people with refractory epilepsy who were 50 years of age and older by analysing data collected during the drug's development.
Data from the period before 30 June 1999 were used to calculate responder rates [seizure reductions greater than or equal to 50%, and greater than or equal to 75%] and freedom from seizures during the previous 6 months and previous year. Adverse event (AE) reports were used to determine tolerability.
Data from a total of 1,422 persons were analysed. From these, 211 persons fit the criteria of the study (50+ years of age with refractory epilepsy). The age range was 50-78 years; the median age 56 years. The median dosage of levetiracetam was 3,000 mg per day; the mean duration of exposure was 697 days. Of these 211 persons, 44% were prescribed 1 additional AED and 43% were prescribed 2 additional AEDs.
At the end of the observation period, 44% were still taking levetiracetam. The rate of discontinuation of therapy was comparable to that of the total participant population: adverse events 20%; insufficient therapeutic effect 16%; completion of the study 12%.
Researchers found that of those persons taking levetiracetam, 37% experienced a 50% or greater reduction in seizure frequency (compared with 39% of the control group) and 19% saw a 75% or greater reduction (compared with 20% in the control group). Freedom from seizures during the 6 months preceding final evaluation was 19% (compared with 12% of the control group); during the year preceding evaluation, 15% (compared with 9% of the control group).
Of the 71 persons taking levetiracem with 1 concomitant AED, 34% were seizure free during the last 6 months (20% of the control group).
Most adverse effects were CNS-related and mild.
Adverse Effects |
| main | control |
somnolence | 26% | 23% |
asthenia | 23% | 23% |
dizziness | 18% | 19% |
confusion | 6% | 4% |
hostility | 1% | 4% |
emotional lability | 3% | 4% |
insomnia | 9% | 7% |
Levetiracetam may have increased benefits for seniors, who often take multiple medications, because of its freedom from interaction with other drugs.
Source
Swiss Epilepsy Centre
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