Low-dose Levetiracetam Associated With High Treatment Success in Childhood Absence Epilepsy

child yellow pill medicine
child yellow pill medicine
The investigators advised that patients who require continued-dose escalation should be transitioned to a first-line therapy for absence epilepsy.
The following article is part of live conference coverage from the 2017 American Epilepsy Society Annual Meeting in Washington, DC. Neurology Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from AES 2017.

WASHINGTON, DC – An association between low doses of levetiracetam and higher rates of treatment success in children with absence epilepsy syndromes has been found, according to findings presented at the 2017 American Epilepsy Society Annual Meeting December 1-5, 2017 in Washington, DC.

“[Although] levetiracetam is prescribed for a broad spectrum of seizure types, it does not have a specific indication for absence epilepsy,” reported the investigators. “Given the common use of this drug in clinical practice, we sought to determine the real-world efficacy of levetiracetam for the treatment of childhood absence epilepsies (CAE) and juvenile absence epilepsies (JAE).”

Investigators conducted a systematic chart review of pediatric patients who were treated for new-onset absence epilepsies. A total of 158 children were included in this analysis, of whom 72 were being treated with levetiracetam.

A large proportion of patients receiving levetiracetam discontinued therapy (74%) due to either treatment-associated side effects (45%) or clinical inefficacy (59%). There was no significant difference among discontinuation of levetiracetam vs other medications with regard to therapy-related side effects (odds ratio [OR] 0.69; 95% CI, 0.36-1.31).

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On pretreatment electroencephalography, polyspikes were found to be somewhat higher in the levetiracetam-effective group (44%) vs the levetiracetam-ineffective group (27%; OR 0.46; 95% CI, 0.15-1.40). Doses for levetiracetam were significantly lower among children who had treatment success vs treatment failure (29 ± 13 mg/kg/d vs 42 ± 20 mg/kg/d, respectively; P =.005).

The investigators stated, “Lack of seizure control requiring continued-dose escalation should prompt early consideration of a therapeutic medication transition from levetiracetam to a first-line absence epilepsy medication.”

Disclosures: The investigators report financial support from the University of Michigan Charles Woodson Fund for Clinical Research.

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Nolan DA, Shellhaas R, Lester S, Rau S. Clinical use and efficacy of levetiracetam for childhood and juvenile absence epilepsies. Presented at: 2017 American Epilepsy Society Annual Meeting. December 1-5, 2017; Washington, DC. Abstract 1.182.