title: Fast and sustained efficacy of levetiracetam during titration and the first 3 months of treatment in refractory epilepsy.
abstract: OBJECTIVE
  To investigate whether the efficacy of levetiracetam (LEV) is sustained in adult patients with refractory partial seizures over a 3-month period.
  
  
  METHODS
  Treatment effect was assessed in a post hoc analysis by determining the proportion of seizure-free days during each week of a 3-month period after the initiation of treatment. Pooled data from three randomized, double-blind, placebo-controlled trials (n = 883) were analyzed.
  
  
  RESULTS
  The mean proportion of seizure-free days was greater in the LEV group than in the placebo group. The difference, which was statistically significant, was observed as early as the first week after the initiation of treatment. It was higher in the first week of treatment and subsequently was maintained for each week over the 3-month period (p < 0.001 or p = 0.002 at each time point). Patients in the LEV group had on average 74% to 81% days each week without any seizure, compared with 69% to 72% in the placebo group.
  
  
  CONCLUSIONS
  LEV is efficient in controlling seizures from the first week of drug initiation, during uptitration, and throughout the first 3 months of treatment. An interesting amplification of efficacy occurs in the first week of therapy, which is intriguing and warrants further investigation.
authors.affiliation: Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: French
authors.forename: Sylvie
authors.initials: S
authors.lastname: di Nicola
authors.forename: Celestina
authors.initials: C
authors.lastname: Arrigo
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D017326:Clinical Trials, Phase III as Topic; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004828:Epilepsies, Partial / Q000188:drug therapy* / Q000517:prevention & control; D005260:Female; D006801:Humans; D000077287:Levetiracetam; D008297:Male; D010889:Piracetam / Q000031:analogs & derivatives* / Q000627:therapeutic use; D010919:Placebos; D016032:Randomized Controlled Trials as Topic; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants; D010919:Placebos; D000077287:Levetiracetam; D010889:Piracetam