An antiepileptic add-on treatment that has been shown to be effective without the need to titrate for tolerability is now available on the PBS

Briviact (brivaracetam) is an add-on therapy for the treatment of partial-onset seizures with or without secondary generalisation in patients from 16 years of age with epilepsy.

The therapy is available in three formulations – oral tablets, oral solution (currently unavailable for supply) or solution for injection by a healthcare professional, when oral administration is temporarily not possible (solution for injection is not PBS reimbursed).

The efficacy of Briviact has been established in three fixed-dose, randomised, double-blind, placebo-controlled, multi-centre studies, across 1,558 patients.

Despite ongoing treatment with one-to-two concomitant antiepileptic drugs (AEDs), the adjunct use of Briviact 100 mg/day was found to be associated with a clinically significant 24.4% reduction in 28-day adjusted seizure frequency over placebo (p<0.001).

Furthermore, over a 12-week period, partial-onset seizures were more than halved from baseline in 39.5% of patients treated with Briviact 100 mg/day.

According to Professor Patrick Kwan, Head of Epilepsy at The Royal Melbourne Hospital and Alfred Hospital, Melbourne, as many as 250,000 Australians are currently living with epilepsy and 800,000 will develop epilepsy in their lifetime.

“People living with epilepsy can face daily challenges due to uncertainty about when they might experience their next seizure. An add-on therapy that can significantly reduce seizure frequency, or even facilitate seizure freedom, is a welcome addition to the array of available AEDs.

“Not everyone responds in the same way to AEDs or their various interactions with other drugs, so therapies such as brivaracetam, that can be taken together with most other medications, antiepileptic or otherwise, have an advantage in implementing personalised seizure management,” says Professor Kwan.

Graeme Shears, CEO Epilepsy Foundation, says less disruptive treatments for epilepsy are crucial to improving patient outcomes.

“Living with epilepsy can significantly impact patients’ lives, if not effectively managed,” Mr Shears says.

“The continued development of improved antiepileptic treatments, minimising disruption to patients’ activities of daily living, is welcomed by patients and carers alike.”

References:

  1. Klein P, Schiemann J, Sperling MR, Whitesides J, Liang W, Stalvey T, Brandt C, & Kwan P. (2015) A randomized, double-blind, placebo-controlled, multicenter, parallel-group study to evaluate the efficacy and safety of adjunctive brivaracetam in adult patients with uncontrolled partial-onset seizures. Epilepsia. 56(12):1890–1898.
  2. Ryvlin P, Werhahn KJ, Blaszczyk B, Johnson ME, & Lu S. (2014) Adjunctive brivaracetam in adults with uncontrolled focal epilepsy: Results from a double-blind, randomized, placebo-controlled trial. Epilepsia. 55(1):47–56.
  3. Biton V, Berkovic SF, Abou-Khalil B, Sperling MR, Johnson ME, & Lu S. (2014) Brivaracetam as adjunctive treatment for uncontrolled partial epilepsy in adults: A phase III randomized, double-blind, placebo-controlled trial. Epilepsia. 55(1):57–66.
  4. Ben-Menachem E, Mameniškienė R, Quarato P, Klein P, Gamage J, Schiemann, J Johnson M, Whitesides J, McDonough B, Eckhardt K (2016) Efficacy and safety of brivaracetam for partial-onset seizures in 3 pooled clinical studies. Neurology, 873:314-323.