Intravenous brivaracetam in status epilepticus: A multicentric retrospective study in Italy.

Autor: Orlandi N; Department of Biomedical, Metabolic and Neural Sciences, Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy; Neurology Department, OCB Hospital, AOU Modena, Italy., Bartolini E; Neurology Unit, Nuovo Ospedale Santo Stefano, USL Centro Toscana, Prato, Italy., Audenino D; Neurology Unit, E.O Ospedali Galliera, Genoa, Italy., Coletti Moja M; Neurology Unit, Mauriziano Umberto I Hospital, Turin, Italy., Urso L; Neurology and Stroke Unit, PO. S. Antonio Abate, Trapani, Italy., d'Orsi G; Epilepsy Centre - S.C. Neurologia Universitaria, Policlinico Riuniti, Foggia, Italy., Pauletto G; Neurology Unit, Department of Neurosciences, Santa Maria Della Misericordia University Hospital, ASUFC, Udine, Italy., Nilo A; Clinical Neurology Unit, Department of Neurosciences, Santa Maria Della Misericordia University Hospital, ASUFC, Udine, Italy., Zinno L; Neurology Unit, Maggiore Hospital, AOU Parma, Italy., Cappellani R; Neurology, Umberto I Hospital, ASP 8 Siracusa, Italy., Zummo L; Neurology and Stroke Unit, P.O. ARNAS-Civico, Palermo, Italy., Giordano A; Neurology Unit, Guizzardi Hospital, Ragusa, Italy., Dainese F; Epilepsy Centre, UOC Neurology, ULSS3 Serenissima, Venice, Italy., Nazerian P; Department of Emergency Medicine, Careggi University Hospital, Florence, Italy., Pescini F; Stroke Unit, Careggi University Hospital, Florence, Italy., Beretta S; Department of Neurology, Ospedale San Gerardo ASST Monza, University of Milano Bicocca, Italy., Dono F; Department of Neuroscience, Imaging and Clinical Science, University 'G. D'Annunzio' of Chieti-Pescara, Italy., Gaudio LD; Neurology Unit, PO San Leonardo, ASL Napoli 3 Sud, Italy., Ferlisi M; Neurology Unit 'A', AOUI Verona, Italy., Marino D; Epilepsy Center, Neurology Unit, Department of Cardio-neuro-vascular Sciences, San Donato Hospital, Arezzo, Italy., Piccioli M; Neurology Unit, PO San Filippo Neri, ASL Roma 1, Italy., Renna R; Neurological Clinic and Stroke Unit - 'A. Cardarelli' Hospital, Naples, Italy., Rosati E; Neurology Unit 2, Careggi University Hospital, Florence, Italy., Rum A; Neurology and Neurophysiopatology Unit, Aurelia Hospital, Rome, Italy., Strigaro G; Neurology Unit, AOU 'Maggiore Della Carità', Novara, Italy., Giovannini G; Neurology Department, OCB Hospital, AOU Modena, Italy., Meletti S; Department of Biomedical, Metabolic and Neural Sciences, Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy; Neurology Department, OCB Hospital, AOU Modena, Italy. Electronic address: stefano.meletti@unimore.it., Cavalli SM; Neurology Unit, Guizzardi Hospital, Ragusa, Italy., Contento M; Neurology Unit 2, Careggi University Hospital, Florence, Italy., Cottone S; Neurology and Stroke Unit, P.O. ARNAS-Civico, Palermo, Italy., Di Claudio MT; Epilepsy Centre - S.C. Neurologia Universitaria, Policlinico Riuniti, Foggia, Italy., Florindo I; Neurology Unit, Maggiore Hospital, AOU Parma, Italy., Guadagni M; Epilepsy Center, Neurology Unit, Department of Cardio-neuro-vascular Sciences, San Donato Hospital, Arezzo, Italy., Kiferle L; Neurology Unit, Nuovo Ospedale Santo Stefano, USL Centro Toscana, Prato, Italy., Lazzaretti D; Department of Emergency Medicine, Careggi University Hospital, Florence, Italy., Lazzari M; Neurology Unit, AOU 'Maggiore Della Carità', Novara, Italy., Coco DL; Neurology and Stroke Unit, P.O. ARNAS-Civico, Palermo, Italy., Pradella S; Neurology Unit, Nuovo Ospedale Santo Stefano, USL Centro Toscana, Prato, Italy., Rikani K; Neurology Unit, E.O Ospedali Galliera, Genoa, Italy., Rodorigo D; Department of Neuroscience, Imaging and Clinical Science, University 'G. D'Annunzio' of Chieti-Pescara, Italy., Sabetta A; Epilepsy Centre - S.C. Neurologia Universitaria, Policlinico Riuniti, Foggia, Italy., Sicurella L; Neurology and Stroke Unit, PO. S. Antonio Abate, Trapani, Italy., Tontini V; Neurology Unit, Maggiore Hospital, AOU Parma, Italy., Turchi G; Neurology Department, OCB Hospital, AOU Modena, Italy., Vaudano AE; Neurology Department, OCB Hospital, AOU Modena, Italy., Zanoni T; Neurology Unit 'A', AOUI Verona, Italy.
Jazyk: angličtina
Zdroj: Seizure [Seizure] 2021 Mar; Vol. 86, pp. 70-76. Date of Electronic Publication: 2021 Jan 30.
DOI: 10.1016/j.seizure.2021.01.014
Abstrakt: Purpose: to evaluate the use, effectiveness, and adverse events of intravenous brivaracetam (BRV) in status epilepticus (SE).
Methods: a retrospective multicentric study involving 24 Italian neurology units was performed from March 2018 to June 2020. A shared case report form was used across participating centres to limit biases of retrospective data collection. Diagnosis and classification of SE followed the 2015 ILAE proposal. We considered a trial with BRV a success when it was the last administered drug prior the clinical and/or EEG resolution of seizures, and the SE did not recur during hospital observation. In addition, we considered cases with early response, defined as SE resolved within 6 h after BRV administration.
Results: 56 patients were included (mean age 62 years; 57 % male). A previous diagnosis of epilepsy was present in 21 (38 %). Regarding SE etiology classification 46 % were acute symptomatic, 18 % remote and 16 % progressive symptomatic. SE episodes with prominent motor features were the majority (80 %). BRV was administered as first drug after benzodiazepine failure in 21 % episodes, while it was used as the second or the third (or more) drug in the 38 % and 38 % of episodes respectively. The median loading dose was 100 mg (range 50-300 mg). BRV was effective in 32 cases (57 %). An early response was documented in 22 patients (39 % of the whole sample). The use of the BRV within 6 h from SE onset was independently associated to an early SE resolution (OR 32; 95 % CI 3.39-202; p = 0.002). No severe treatment emergent adverse events were observed.
Conclusion: BRV proved to be useful and safe for the treatment of SE. Time to seizures resolution appears shorter when it is administered in the early phases of SE.
(Copyright © 2021 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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