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Levetiracetam Helps Control Refractory Partial Seizures

Levetiracetam offers sustained seizure control to patients with refractory partial epilepsy, according to a retrospective study.

In a study led by E. Ben-Menachem from the department of clinical neurosciences, section of neurology, Sahlgren University Hospital, Goteborg, Sweden, researchers collected medical data on 1,422 patients with refractory epilepsy who were treated with levetiracetam. They examined changes in seizure frequency as well as adverse events that the patients experienced while taking the drug in order to determine its efficacy and tolerability for this indication.

Patients took levetiracetam for one to eight years, and the median period of treatment was 399 days. Overall, the median percent reduction in seizure frequency with levetiracetam, compared with baseline, was 39.6%.

There was no continued decrease in seizure frequency with ongoing levetiracetam therapy among patients taking the drug for periods ranging from 6 to 54 months. During the first three months of treatment with levetiracetam, 39.2% of patients responded to the drug. At six months, the proportion was similar, at 36.1%.

Overall, 38.6% of patients experienced reductions in seizure frequency of at least 50%, and 20.1% experienced reductions in seizure frequency of at least 75%. Over the entire treatment period, 4.6% of patients became seizure-free with levetiracetam. At six months follow-up, 11.7% of patients were seizure-free, and at 12 months follow-up, 8.9% of patients were seizure-free. Among the 491 patients who took only one other anti-epileptic drug alone with levetiracetam, 19.8% were seizure-free during their last six months of treatment.

Two hundred and five or 14.4% of patients reduced the number of concomitant anti-epileptic drugs they were taking while on levetiracetam. At the end of the follow-up period, 5.5% of patients were taking levetiracetam alone.

The most common adverse events experienced by patients taking levetiracetam were accidental injury in 28.0%, infection in 26.6%, headache in 25.8%, somnolence in 23.0%, asthenia in 22.6% and dizziness in 18.9%.

Based on these findings, the authors concluded that levetiracetam has sustained efficacy for the control of seizures in patients with refractory partial epilepsy. The long-term tolerability of this drug is similar to that seen in short-term trials.
Epilepsy Res 2003 Feb;53:1-2:57-64. "Evidence for sustained efficacy of levetiracetam as add-on epilepsy therapy."

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