Source: DGNews  |  Posted 4 years ago

By Bryan DeBusk, PhD

PHILADELPHIA, PA -- December 4, 2007 -- After 6 weeks of leviteracetam treatment, 73% more epilepsy patients are seizure free compared with patients on lamotrigine and 54% more compared with patients on topiramate, according to results presented at the 61st Annual Meeting of the American Epilepsy Society.

The study was presented in a late breaking abstract session on December 2nd by Graeme Sills, PhD, Lecturer of Neurological Science, University of Liverpool, Liverpool, United Kingdom.

The researchers conducted a randomised, open-label trial with 251 patients to examine the differences in efficacy of three antiepileptic drugs after 6 weeks of treatment: 81 patients received leviteracetam (LEV); 85 received topiramate (TPM); and 85 received lamotrigine (LTG).

Patient target doses were titrated to 1000 mg LEV over 2 weeks, 100 mg TPM over 4 weeks, or 150 mg LTG over 6 weeks. At baseline and at each clinic visit, physicians examined clinical status, seizure diaries, adverse events, Addenbrookes Cognitive Exam, the Center for Epidemiologic Studies Depression scale, Health & Healthcare questionnaire, Patient-Weighted Quality of Life Questionnaire (QOLIE-31P), and standard blood tests.

At baseline no significant differences were noted among the groups for age, gender, weight, epilepsy type, monthly seizure frequency, or scores on any of the standardised evaluations.

After 6 weeks of treatment, 63% of patients on LEV were seizure free compared with 41.2% on TPM (P <.01) and 36.5% on LTG (P <.005).

Based on the percentage of patients reaching the target dose within 6 weeks, the researchers concluded that the primary differences in rates of seizure freedom may be related in part to the rate of titration. By 6 weeks, 93.2% of LEV patients had reached the target dose compared with 85.1% of patients on TPM and 31.2% of patients on LTG patients.

The researchers will continue to follow these patients to determine the long-term efficacy of these three antiepileptic drugs in maintaining seizure freedom and in affecting other measures of epilepsy control.

Although the therapeutic goal for most patients is long-term control, Dr. Sills noted that these results have clinical importance for a select group of patients. "People are more interested in long-term efficacy, but the suggestion might be that if you have a patient who has frequent seizures and whom you want to get early control over those frequent seizures, then it may be advantageous to use leviteracetam," he said.

Funding for this study was obtained from an unrestricted educational grant from UCB Pharma, which markets leviteracetam under the trade name Keppra.

[Presentation title: Titration Influences Short-Term Efficacy of Monotherapy in Newly-Diagnosed Epilepsy. Late Breaking Abstract]