title: Brivaracetam: new compound approved for the treatment of epilepsy.
abstract: Brivaracetam was approved in the E.U. and U.S. at the beginning of 2016 for the adjunctive treatment of focal epilepsies in patients over 16 years of age. This compound is a novel high-affinity synaptic vesicle glycoprotein 2A (SV2A) ligand, with a selectivity for this protein that is 10- to 30-fold higher than that shown by levetiracetam. Preclinical studies show that brivaracetam might have a stronger anticonvulsant effect and distributes in the brain more quickly, when compared to levetiracetam. The agent has linear and simple pharmacokinetics and a low interaction potential. Six double-blind placebo-controlled studies have assessed doses from 5 to 200 mg/day. Significant efficacy has been observed from doses of 50 mg/day, but there was not a clear dose-effect relationship. Short-term tolerability was excellent with all doses. Adverse events significantly associated with brivaracetam were dizziness, somnolence, fatigue and irritability. An excellent tolerability profile has been found after administration of a formulation for intravenous use.
authors.affiliation: Unit of Neurology, Department of Medicine, Florence Health Authority, Firenze, Italy. gaetano.zaccara@uslcentro.toscana.it.
authors.forename: G
authors.initials: G
authors.lastname: Zaccara
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D004827:Epilepsy / Q000188:drug therapy*; D006801:Humans; D011760:Pyrrolidinones / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*
chemical_list: D000927:Anticonvulsants; D011760:Pyrrolidinones; C482793:brivaracetam
keywords: Antiepileptic drugs; Brivaracetam; Drug development – Clinical trials; Epilepsy; Levetiracetam