Levetiracetam as first‐line monotherapy for Idiopathic Generalized Epilepsy in women

• Published in: Acta neurologica Scandinavica Vol. 143; no. 4; pp. 407 - 412
• Main Authors: Ballvé, Alejandro, Salas‐Puig, Javier, Quintana, Manuel, Campos, Daniel, Llauradó, Arnau, Raspall, Miquel, Fonseca, Elena, Abraira, Laura, Santamarina, Estevo, Toledo, Manuel
• Format: Journal Article
• Language: English
• Published: Denmark Hindawi Limited 01.04.2021
• Subjects: Adolescent; Adult; Anticonvulsants - therapeutic use; childbearing; Convulsions & seizures; Epilepsy; Epilepsy, Generalized - diagnosis; Epilepsy, Generalized - drug therapy; Etiracetam; Female; Follow-Up Studies; genetic generalized epilepsy; Humans; idiopathic generalized; Immunoglobulin E; levetiracetam; Levetiracetam - therapeutic use; Piracetam - therapeutic use; Population studies; Retrospective Studies; Seizures; Side effects; Treatment Outcome; Valproic acid; Valproic Acid - therapeutic use; women; Young Adult; epilepsy; idiopathic generalized; childbearing; genetic generalized epilepsy; levetiracetam; women
• ISSN: 0001-6314; 1600-0404
• DOI: 10.1111/ane.13389

Background Levetiracetam (LEV) is effective in Idiopathic Generalized Epilepsy (IGE) and seems to be a good alternative to valproic acid in women of childbearing age. However, there is lack of approval for this indication as monotherapy. The aim of this study is to assess the efficacy of LEV as a first‐line therapy in this population. Methods The study is a descriptive analysis of women aged between 16 and 45 years old diagnosed with IGE and treated with LEV as first‐line monotherapy. Minimum follow‐up was 24 months. Results 26 women. Mean age: 25.4 years (17–43). 14 Juvenile Myoclonic Epilepsy; 8 Tonic‐Clonic Seizures Alone; 4 Juvenile Absence. Mean follow‐up: 68.3 months (24–120). 11 patients (40.7%) continued to take LEV as monotherapy, of which 10 were seizure‐free, and three (11.5%) continue to be seizure‐free after withdrawing LEV. 12 patients (46.2%) required a change of treatment: 25% (3/12) due to lack of efficacy, 42% (5/12) due to adverse effects and 33% (4/12) due to both. Irritability was the most frequent adverse effect. At the last assessment, three patients (11.5%) continued to have seizures despite polytherapy. Estimated retention rates were 78.1% at one year (SE 7.3%) and 51% at 5 years (SE 9.8%). Estimated median retention time is 72 months (CI 95%: 50.9–93.1). Conclusion LEV could be an effective drug as first‐line treatment for IGE in women of childbearing potential. The adverse effects are its main limitation. Comparative studies are needed in order to establish it for this indication.