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Levetiracetam May Have New Role in Monotherapy for Epilepsy: Presented at AES

By Bonnie Darves

BOSTON, MA -- December 15, 2003 -- A drug that has quietly developed a following as off-label monotherapy for epilepsy treatment, levetiracetam (LEV), may soon hit the mainstream, based on results of a new study presented here December 9^th at the American Epilepsy Society 57^th Annual Meeting.

Researchers from two centres in the United States, the Minnesota Epilepsy Center in St. Paul and University of California, in Davis, California, United States, have found that adult patients and even the elderly -- who may incur renal and other problems when taking antiepileptic drugs (AEDs) -- appear to both tolerate LEV and to benefit in seizure reduction.

In the Minnesota study of 33 elderly patients (mean age 66 years), 15 received LEV as a first-line therapy or were later converted to it; 57% became seizure-free after 6 months of treatment. The mean dose was 1,832 mg daily, and adverse events were minimal.

In the University of California-Davis study of 30 adult patients who took LEV as monotherapy for 1 year, 53% became seizure free -- including 3 patients who had not responded to previous treatment and had a 75% reduction in seizures. The mean dose was 1,854 mg/day.

In the California study of 41 patients with partial seizures (mean age 41.1 years), 53% of the 30 patients included in analysis were seizure-free at the 1-year follow-up. Twenty-four of the patients included in the analysis had failed monotherapy with other AEDs, including Dilantin, Tegretol, Depakote, Lamictal, and Topamax. AEs were also minimal in this study.

Lead investigators of both studies said their results suggest that LEV, approved by the United States Food & Drug Administration 4 years ago for adjunctive-therapy treatment of partial seizures, may be both effective and well tolerated in adults with either new-onset or intractable epilepsy. Large, prospective, randomised, double-blind studies are needed to confirm the findings, the researchers acknowledged.

Both of these studies were supported by UCB Pharma.


[Study Titles: Levetiracetam Monotherapy For Elderly Patients With Epilepsy. Abstract 1305; Clinical Experience of Levetiracetam Monotherapy for Adults With Epilepsy: One-Year Follow-up Study. Abstract 1294]

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