How does brivaracetam compare with placebo for reducing seizures in adults and adolescents with drug-resistant epilepsy?

Abstract

Adults and adolescents with drug‐resistant epilepsy probably benefit from treatment with brivaracetam, but a few may experience adverse events leading to withdrawal from treatment.Compared with placebo for adults and adolescents with drug‐resistant epilepsy, brivaracetam 5 to 200 mg/d in two equally divided doses led to a 50% or greater reduction in seizure frequency in more people (313 vs 173 per 1000 people; all results on average) and to more people being completely seizure free; however, low event rates preclude calculation of absolute numbers (moderate‐certainty evidence for both outcomes). There was no statistically significant difference between groups in withdrawal for any cause, but the proportion of people who withdrew from treatment due to adverse events was higher with brivaracetam than with placebo (59 vs 38 per 1000 people) (low‐certainty evidence for both outcomes). Moderate‐certainty evidence shows that slightly more people experienced any adverse event with brivaracetam than with placebo (637 vs 589 per 1000 people).