SACRAMENTO, Calif. -- Two studies by physicians at UC Davis Medical Center have found that levetiracetam, an antiepileptic drug typically used in combination with other drugs, is effective as a single therapy for adult and elderly patients. The studies, presented today at the American Epilepsy Association conference in Boston, are significant because single-drug therapy is a much easier course of treatment and may be an option for some 13 million epilepsy patients worldwide who currently use multiple medications to control epileptic seizures.
Epilepsy is a neurological disorder characterized by seizures, which are recurring disturbances in the normal electrical function of the brain. The causes of epilepsy are only partially understood.
"We found that levetiracetam monotherapy can be effective and well-tolerated in adults with new onset and difficult-to-control epilepsy and that most patients were able to remain seizure-free at one-year follow-up," said Taoufik M. Alsaadi, assistant professor of neurology and director of the UC Davis Epilepsy Treatment Center at UC Davis.
The UC Davis study compared the efficacy of levetiracetam at one year to a 6-month study conducted previously at the UC Davis Epilepsy Treatment Center. The one-year study included 30 patients, ages 18-91, with a history of partial seizures over a period of one to 30 years. Six patients began levetiracetam as first-line therapy.
Twenty-four patients converted to levetiracetam monotherapy after failing prior antiepileptic medications, such as phenytoin sodium, carbamazepine, divalproex sodium, lamotrigine and topiramate.
After one year on levetiracetam, 16 of 30 patients (53 percent) were seizure-free. Four patients had more than a 75 percent reduction in seizures. Seven patients experienced more than a 50 percent reduction in seizures. Two patients had more than a 25 percent, but less than a 50 percent reduction in seizures, and one patient had no significant change in the frequency of seizure.
"Most patients who took keppra for six months continued to benefit from the therapy after one year," Alsaadi said. "This treatment shows promise for improving the quality of life for people suffering from epilepsy, but a larger, double-blind study is needed to confirm findings."
In the study of seniors, UC Davis researchers assessed how well patients could tolerate levetiracetam. Elderly patients have increased sensitivity to the effects of antiepileptic drugs. To investigate efficacy and tolerability of the medication, researchers identified 33 patients for a retrospective study. Of those, 15 patients, ages 62 to 92, began levetiracetam either as first-line therapy or were converted to levetiracetam monotherapy after failing other antiepileptic medications. The duration of epilepsy ranged from 1 to 39 years.
Six patients had an identifiable cause to their seizures: three had seizures secondary to head trauma, two experienced strokes and one had seizures resulting from Alzheimer's disease. Researchers noted each patient's seizure type and frequency for two months before and then six months following levetiracetam monotherapy.
Of 15 patients, eight became seizure-free. Three patients had more than a 75 percent reduction in seizures and three patients had more than a 50 percent reduction in seizures. One patient didn't continue with follow-up.
One patient reported dizziness within days after starting levetiracetam, but was able to continue on the medication. No other side effects were reported.
"We found that levetiracetam may be an acceptable choice for the elderly," Alsaadi said. "We didn't see the usual side effects associated with the older antiepileptic drugs."
UCB Pharma, a global pharmaceutical company based in Belgium, manufactures levetiracetam under the commercial name Keppra TM.
The study was funded by the UC Davis Epilepsy Treatment Center.
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