Evidence map›Paper›PMID 37610448›Full record

ArticleJournal of neurology2023

Rapid switching from levetiracetam to brivaracetam in pharmaco-resistant epilepsy in people with and without intellectual disabilities: a naturalistic case control study.

L V Watkins, H Dunstall, C Musicha, C Lawthom, K John, C Bright, C Richings, K Harding, S Moon, S E Pape and 6 more

Abstract read
PubMed Publisher
In one paragraph

Article in Journal of neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.6field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 7 citations in OpenAlex.

  1. Trial
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 7 institutions in 1 country.

L V WatkinsSwansea Bay University Health Board, Port Talbot, UK.
H DunstallSwansea Bay University Health Board, Port Talbot, UK.
C MusichaUniversity of Plymouth, Plymouth, UK.
C LawthomAneurin Bevan University Health Board, Newport, UK.
K JohnAneurin Bevan University Health Board, Newport, UK.
C BrightUniversity of South Wales, Aberdare, UK.
C RichingsAneurin Bevan University Health Board, Newport, UK.
K HardingAneurin Bevan University Health Board, Newport, UK.
S MoonSwansea Bay University Health Board, Port Talbot, UK.
S E PapeOxleas NHS Foundation Trust, Kent, UK.
R WinterhalderOxleas NHS Foundation Trust, Kent, UK.
V AllgarUniversity of Plymouth, Plymouth, UK.
R H ThomasNewcastle University, Newcastle upon Tyne, UK.
B McLeanUniversity of Plymouth, Plymouth, UK.
R LaugharneUniversity of Plymouth, Plymouth, UK.
Rohit ShankarUniversity of Plymouth, Plymouth, UK. Rohit.shankar@plymouth.ac.uk.ORCID http://orcid.org/0000-0002-1183-6933
Aneurin Bevan University Health Board · GBUniversity of Plymouth · GBOxleas NHS Foundation Trust · GBSwansea Bay University Health Board · GBUniversity of South Wales · GBCornwall Partnership NHS Foundation Trust · GBNewcastle upon Tyne Hospitals NHS Foundation Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundApproximately one quarter of people with an intellectual disability (PwID) have epilepsy of whom nearly three-quarters are pharmaco-resistant. There are higher reported neuropsychiatric side-effects to anti-seizure medication (ASM) in this group. Levetiracetam (LEV) is a first-line ASM with a stronger association with neuropsychiatric symptoms for PwID than other ASMs. Brivaracetam (BRV) is a newer ASM. Recent studies suggest a beneficial effect of swapping people who experience neuropsychiatric events with LEV to BRV. However, there is limited evidence of this for PwID. This evaluation analyses real world outcomes of LEV to BRV swap for PwID compared to those without ID.

methodsWe performed a multicentre, retrospective review of clinical records. Demographic, clinical characteristics and reported adverse events of patients switched from LEV to BRV (2016-2020) were recorded at 3 months pre and 6- and 12-month post-BRV initiation. Outcomes were compared between PwID and those without and summarised using cross-tabulations and logistic regression models. A Bonferroni correction was applied.

resultsOf 77 participants, 46 had ID and 52% had a past psychiatric illness. 71% participants switched overnight from LEV to BRV. Seizure reduction of > 50% was seen in 40% patients. Psychiatric illness history was predictive of having neuropsychiatric side-effects with LEV but not BRV (p = 0.001). There was no significant difference for any primary outcomes between PwID versus without ID.

conclusionsSwitching from LEV to BRV appears as well tolerated and efficacious in PwID as those without ID with over 90% still on BRV after 12 months.

Indexed as

Drug-Related Side Effects and Adverse ReactionsEpilepsyIntellectual DisabilitySubstance Abuse, IntravenousAnticonvulsantsCase-Control StudiesHumansLevetiracetamPyrrolidinonesTreatment OutcomeAnticonvulsantsbrivaracetamLevetiracetamPyrrolidinonesCross taperDevelopmental disabilitesMulitmorbidityNewer anti-seizure medicationRapid switchingSUDEP

Identifiers

PMID37610448
OpenAlexW4386084747

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.