title: The efficacy and safety of brivaracetam at different doses for partial-onset epilepsy: a meta-analysis of placebo-controlled studies.
abstract: OBJECTIVE
  This meta-analysis systematically assessed the efficacy and safety of different doses of brivaracetam (BRV) compared with placebo as adjunctive therapy for adults with partial-onset epilepsy.
  
  
  METHODS
  Electronic and clinical trials databases were searched for randomized controlled trials of BRV published up to May 2015. We assessed the risk of bias of the included studies using the Cochrane Risk of Bias tool. The outcomes of interest included 50% responder rates, seizure freedom, the incidence of withdrawal and treatment-emergent adverse events (TEAEs).
  
  
  RESULTS
  Five trials met the inclusion criteria. Compared with placebo, 20, 50, 100 and 150 mg/day BRV was associated with significantly higher 50% responder rates. In addition, the effect of 50 mg BRV on seizure freedom was significantly different than that of placebo. Both fatigue and nasopharyngitis were significantly associated with 20 mg BRV, whereas fatigue and irritability were associated with 50 mg BRV. Somnolence was associated with 150 mg BRV. No significant differences were observed for the other common TEAEs.
  
  
  CONCLUSIONS
  The use of BRV at doses > 5 mg/day resulted in statistically significant reduction in seizure frequency in respect to the 50% responder rate. BRV was reasonably tolerated by patients. These findings warrant confirmation in future studies.
authors.affiliation: The First Affiliated Hospital of Chongqing Medical University, Department of Neurology , No.1 Youyi Road, Chongqing, 400016 , China +86 136 2835 9876 ; +86 023 8901 2878 ; xfyp@163.com.
authors.forename: Xin
authors.initials: X
authors.lastname: Tian
authors.forename: Meizhen
authors.initials: M
authors.lastname: Yuan
authors.forename: Qingju
authors.initials: Q
authors.lastname: Zhou
authors.forename: Xuefeng
authors.initials: X
authors.lastname: Wang
mesh_terms: D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D004828:Epilepsies, Partial / Q000188:drug therapy* / Q000503:physiopathology; D005221:Fatigue / Q000139:chemically induced; D006801:Humans; D007508:Irritable Mood / Q000187:drug effects; D015990:Placebo Effect; D011760:Pyrrolidinones / Q000009:adverse effects / Q000627:therapeutic use*; D012640:Seizures / Q000188:drug therapy / Q000503:physiopathology; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants; D011760:Pyrrolidinones; C482793:brivaracetam
keywords: antiepileptic drugs; brivaracetam; epilepsy; meta-analysis; partial-onset seizures