Background:
Epilepsy is a common symptom of
brain tumors and is often pharmacoresistent. Among new antiseizure medications (ASMs)
Brivaracetam (BRV) has been approved as adjunctive treatment for
focal seizures and it was tested in non-oncological patient populations. This is the first study that retrospectively explored efficacy and tolerability of BRV as add-on
therapy in
brain tumor-related
epilepsy (BTRE) patients. Materials and Methods: We reviewed the medical records of 33 BTRE patients from six Italian
epilepsy centers; charts included
tumor history, diagnosis of BTRE, BRV added as first or second add-on for uncontrolled
seizures and/or adverse events (AEs) of the previous ASMs, at least 1-month follow-up, seizure frequency, and AEs assessment. Results: Thirty-three patients (19 males, mean age: 57.6 years; 14 females, mean age: 42.4 years): 11 low grade
gliomas, five high grade
gliomas, six
meningiomas, 10
glioblastomas, one primary cerebral
lymphoma. Fourteen patients had focal aware
seizures, nine focal unaware, seven focal to bilateral
tonic-clonic seizures, three patients presented more than one seizure type: focal unaware with focal to bilateral
tonic clonic seizures (two patients) and focal aware and unaware
seizures (one patient). Mean seizure frequency in the month preceding BRV introduction: 7.0; at last follow-up: 2.0 (p = 0.001). Seven patients (21.2%) reported AEs (anxiety, agitation,
fatigue,
vertigo) and three of them (9.0%) required
drug withdrawal due to psychiatric adverse events (
PAEs). Three other patients withdrew BRV: one for scarce compliance (3.0%), two for uncontrolled
seizures (6.0%). Conclusion: Our results showed that BRV could be a new therapeutic option effective in reducing
seizures in BTRE patients, taking into account the incidence of
PAEs in this particular population. Future and larger prospective studies are needed.