Long-term levetiracetam treatment in patients with epilepsy: 3-year follow up

Kuba R, Novotná I, Brázdil M, Kočvarová J, Tyrlíková I, Mastík J, Rektor I. Long-term levetiracetam treatment in patients with epilepsy: 3-year follow up.Acta Neurol Scand: 2010: 121: 83–88.© 2009 The Authors Journal compilation © 2009 Blackwell Munksgaard. Objectives – To assess the long-term efficacy and tolerability of levetiracetam in routine clinical practice. Materials and methods – We retrospectively analysed 218 patients, mostly adults, presenting mostly with localisation-related epilepsy, treated with levetiracetam as adjunctive therapy or monotherapy for up to 36 months. The primary points evaluated were: long-term retention rate, reasons for discontinuing levetiracetam and the percentage of seizure-free patients. Results – The retention rate at 6, 12, 24 and 36 months following the commencement of levetiracetam treatment was 91.7, 75.2, 60.1 and 53.7% respectively. Sixty-seven (30.7%) patients discontinued levetiracetam treatment. During the clinical audit evaluation period, surgical resection or implantation of VNS was performed in 31 (14.3%) patients. In 53 of the 67 patients (79.1%), the treatment was discontinued due to lack of efficacy; in 14 patients (20.9%) treatment was discontinued due to adverse events. In total, 24 of 218 patients (11.0%) were seizure-free for 36 months. Conclusions – Levetiracetam is an effective and well-tolerated option for long-term treatment of epilepsy in adults.