Sustained seizure freedom with adjunctive brivaracetam in patients with focal-onset seizures

The maintenance of seizure control over time is a clinical priority in patients with epilepsy. The aim of this study was to assess the sustained seizure frequency reduction with adjunctive brivaracetam (BRV) in real-world practice. Patients with focal epilepsy prescribed to add-on BRV were identified. Study outcomes included the sustained seizure freedom and sustained seizure response, defined as a 100% and a ≥50% reduction in baseline seizure frequency that continued without interruption and without BRV withdrawal through the 12-month follow-up. Nine-hundred and ninety-four patients with a median age of 45 (interquartile range 32-56) years were included. During the 1-year study period, sustained seizure freedom was achieved by 142 (14.3%) patients, of which 72 (50.7%) were seizure free from day-1 of BRV treatment. Sustained seizure freedom was maintained for ≥6, ≥9, and 12 months by 14.3%, 11.9% and 7.2% patients of the study cohort. Sustained seizure response was reached by 383 (38.5%) patients: 236/383 (61.6%) achieved sustained ≥50% reduction in seizure frequency by day-1, 94/383 (24.5%) by month-4, and 53/383 (13.8%) by month-7 up to month-12. Adjunctive BRV was associated with sustained seizure frequency reduction since the first day of treatment in a subset of patients with uncontrolled focal epilepsy.