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Keppra (Levetiracetam) Safe, Effective in Elderly Population With Epilepsy: Presented at AES
By Bonnie Darves
BOSTON, MA -- December 15, 2003 -- Keppra (levetiracetam) as monotherapy appears to provide good seizure control in elderly patients with epilepsy, according to results of a study presented here December 9th at the American Epilepsy Society Annual Meeting.
According to researchers from University Hospitals, Cleveland, Ohio, United States, Keppra monotherapy achieved a 70% reduction in seizure frequency in patients who switched from other therapies.
In addition, those patients also appeared to gain improved cognition when switched to Keppra, an important benefit considering that elderly persons with epilepsy are often on multiple medications for comorbid conditions, said lead researchers Mary Ann Werz, MD, PhD, director, Comprehensive Epilepsy Program, University Hospitals.
"We found that [Keppra] not only reduced their seizure [frequency] but also improved patients' cognition -- even in those who had have had epilepsy for decades," she said, adding that some of the 18 patients in the study were taking more than three medications for other conditions.
Keppra may have an added attraction in respect to safety, she said, because unlike other antiepileptic drugs, it is cleared in the kidneys rather than the liver.
In the study, patients with a median age of 76 years received doses ranging from 500 to 1,000 mg/day for up to 17 months. Serum creatinine levels were closely monitored. Twelve of the patients had a median seizure duration of 29 years prior to starting treatment with Keppra.
To date, five patients have been seizure free for a period ranging from 5 to 17 months, and two patients with recent-onset of seizures experienced a 75% reduction in seizures. Twelve patients reported improved cognition after switching to the drug, and only one required discontinuation of therapy due to an adverse event.
Dr. Werz suggested that although further studies are needed, Keppra may emerge as a first-line therapy for patients with refractory epilepsy whose tolerance for first-generation antiepileptic agents has decreased.
[Study title: Levetiracetam Therapy for Epilepsy: Use and Tolerability in the Elderly. Abstract 2.307]
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