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Antiepilepsy Drug Levetiracetam (Keppra) Reduces Seizures in Brain Tumour Patients: Presented at AAN

By Ed Susman

MIAMI, FL -- April 13, 2005 -- Treatment with the anticonvulsant levetiracetam (Keppra) can prevent seizures among patients with malignant brain seizures and reduce the risk of drug-drug interactions that could compromise chemotherapy regimens.

"Brain tumour patients are often on multiple medications and drug interactions can cause significant problems," said Glen Stevens, MD, section head of adult neuro-oncology, Cleveland Clinic, Cleveland, Ohio, United States.

The study's findings were presented in a poster session here at the American Academy of Neurology 57^th Annual Meeting.

"For the past 3 years we have been converting our brain tumour patients who require anticonvulsants to levetiracetam (Keppra), which is a nonhepatic enzyme inducer," Dr. Stevens said. "We found levetiracetam to be well tolerated and an effective drug to control seizures in brain tumour patients."

Dr. Stevens said that 70% of 278 patients were maintained on levetiracetam as monotherapy. Of patients treated with levetiracetam, 60% achieved a 50% reduction in seizure frequency.

Similar results were observed in a separate study by Herbert Newton, MD, professor of neurology, paediatrics, and oncology, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Ohio State University, Columbus, Ohio, United States.

Dr. Newton also presented his study's findings at the AAN meeting.

"We didn't look at whether treatment with levetiracetam improves outcomes such as mortality," Dr. Newton said, "but it is possible that by using a drug that doesn't interfere with chemotherapy we might be able to improve results."

However, Dr. Newton said the study indicated a major improvement in quality of life for brain tumour patients by preventing seizures that occurred as infrequently as once a month to a frequently as 20 times a day. The average patient in his study had seizures about 3 times a day.

"We saw an 87% reduction in seizures overall," said Samuel Goldlust, MD, a researcher at Ohio State who will begin an internship in May at New York University Medical School. "About 59% of our patients on levetiracetam were seizure free."

The 41 patients in the Ohio State study included people who experienced seizures with primary brain cancers or patients with brain metastases.

Levetiracetam appeared to produce somnolence in about 37% of patients, but patients did not have to come off the medication, Dr. Goldlust said.

Dr. Stevens noted that levetiracetam is approved as add-on medication for patients with focal epilepsy. The drug is not metabolized by the cytochrome P-450 system and has no protein binding which makes it an excellent candidate for use in brain tumour patients.

Further clinical trail will be needed before levetiracetam can be recommended as a first-line treatment in brain tumour patients, he said.


[Presentation title: Retrospective Analysis of Levetiracetam for the Treatment of Seizures in Brain Tumor Patients. Abstract P65. Levetiracetam Use in Brain Tumor Patients. Abstract P66]

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