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New Data Show Keppra (Levetiracetam ) May Be Effective In Difficult-To-Treat Childhood-Onset Epilepsy: Presented at CNS

WASHINGTON, DC and SAVANNAH, GA-- October 11, 2002 -- The second-generation antiepileptic drug (AED) Keppra (levetiracetam) led to a more than 80 percent reduction in both partial and generalized epilepsy that begins in childhood and becomes resistant to standard AED treatments, according to a new study presented at the Child Neurology Society annual meeting today.

While epilepsy can begin at any time in one's life, 50 percent of all cases begin before the age of 25. There are currently over half a million cases of epilepsy in children 18 years of age and under in the United States, according to the National Center for Health Statistics.

In managing patients with childhood-onset epilepsy, physicians are often faced with the challenge of resistance to medications, leading to limited treatment options. More than 30 percent of all patients with epilepsy have inadequate control of seizures with their current drug therapy.

"For physicians, the most frustrating point in the treatment of people with epilepsy, especially in children and young adults, is when all treatment options have been explored, and even the 'best' available option is not working as effectively as expected," said Michael Hemphill, M.D., lead author of the study, a neurologist at the Memorial Health Georgia Neurological Institute and associate clinical professor of neurology at the Medical College of Georgia. "With the addition of Keppra, we have witnessed a dramatic reduction in seizures, and that makes it a welcome addition to our treatment options."

Study Design and Results
Investigators conducted a retrospective chart review of 73 patients (36 male and 37 female) between the ages of three and 28 (mean age 10.92 years), diagnosed with both partial and generalized seizures that were unresponsive to standard AEDs. Each patient was diagnosed with epilepsy during childhood and the mean age of onset of seizures was 6.2 years. Keppra was administered as monotherapy in 18 patients at baseline, and by follow up (mean time of treatment 16 months, ranging between three and 28 months), an additional five patients had been titrated to monotherapy. All others received Keppra as an add-on therapy while taking an average of 2.8 other AEDs. Doses of Keppra ranged from 250-3000 mg/day after three months of treatment.

At baseline, seizure frequency averaged 9.35 seizures per week, and after three months of treatment with Keppra, there was a 52 percent average decrease (4.5 seizures/week). By follow up, weekly seizure frequency had decreased 88 percent (mean 1.13 seizures/week). In those patients with generalized seizures (n=32), the mean weekly seizure frequency of 14.17 at baseline fell to 6.03 at three months and 1.68 at follow up. Similarly, for partial seizures (n=41), mean weekly seizure frequency went from 5.59 at baseline to 3.31 at 3 months and down to 0.63 - less than one per week - at follow up.

Keppra was both tolerated and efficacious in 90 percent of all patients reviewed. One patient reported drowsiness/dizziness and two reported aggressive behavior.

"Since childhood-onset epilepsy is difficult to treat, physicians can spend years attempting to achieve seizure control in their patients using many different medications, even into young adulthood," said Dr. Hemphill. "With this data, we saw that Keppra prompted an almost immediate reduction in seizures. I would encourage physicians to consider using Keppra with other first line treatments for epilepsy."

Keppra tablets have been approved by the U.S. Food and Drug Administration for the adjunctive treatment of partial onset seizures in adults with epilepsy.

The Memorial Health Georgia Neurological Institute provides comprehensive diagnosis, treatment, rehabilitation and research of neurological disorders. The Institute treats patients of all ages and conditions. Special programs are offered for childhood learning disorders, headaches and other recurring pain conditions, epilepsy, stroke, and movement and memory disorders associated with aging.
Memorial Health is a two-state healthcare organization serving a 35-county area in southeast Georgia and southern South Carolina. The system includes its flagship Memorial Health University Medical Center, a 530-bed tertiary medical center; CareOne, its two-state home care division; Memorial Health University Physicians, the area's largest group practice; a major medical education program; business and industry services; and NurseOne, a 24-hour call center. Visit the Memorial Health Web site at www.memorialhealth.com.

SOURCE: Memorial Health Georgia Neurological Institute

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