Placement of Oral Formulations of Brivaracetam in Various Patient Profiles: An Indian Perspective

Brivaracetam (BRV), an analog of levetiracetam (LEV), lowers seizure frequency through a unique mechanism. Although BRV is approved for focal epilepsy in patients aged >1 month (by the US Food and Drug Administration) or >16 years (in India), clinical studies have suggested its potential role in other indications such as generalized seizures, secondarily generalized tonic-clonic seizures, and drug-resistant focal epilepsy, and in certain special populations. Here, we discuss the potential role of BRV in different patient populations and present expert opinions for positioning the pre-existing and newly available oral formulations of BRV to aid both clinicians and diverse patient groupswith a simple and easy dosing and titration-based treatment, including safe and effective switching from LEV to BRV.

Brivaracetam Intravenous Formulation in Epilepsy Management in India : A Position Statement

Brivaracetam (BRV), a propyl analog of levetiracetam, has been shown to be safe and effective in Indian patients with uncontrolled focal epilepsy. A series of advisory board meetings involving pediatricians, neurologists, and physicians were held across India to evaluate the role of IV BRV in India and formulate a position statement. The panelists opined that the potential role of BRV in the acute management of increased seizure activity, especially status epilepticus, should be explored in the Indian context. Further, there is a dearth of Indian studies on the use of BRV in epilepsy patients aged below 16 years. IV BRV holds great potential to be the therapy of choice in epilepsy management owing to the fast mode of action and lesser risk of adverse effects.

From levetiracetam to brivaracetam: Development of antiepileptic drugs / 第二军医大学学报

Epilepsy is a chronic neurological disorder with different etiologies. Despite of many antiepileptic drugs (AEDs) used in clinical treatment, about 30% of the patients have uncontrolled onset, and combined use of different AEDs or new AEDs are needed. The new AEDs should have satisfactory clinical efficacy, tolerability and pharmacokinetic properties, and minimal adverse effects. By now there have been about 20 novel AEDs; most of them are derivatives or analogues of current AEDs. Brivaracetam (BRI) is the derivative of levetiracetam (LEV). This review summarizes the mechanisms of action, pharmacokinetic profiles, tolerability, pharmacology and toxicology, and side effects of LEV and its derivative BRI.