Recent updates on Levetiracetam

Gajanan Panchal, Salil Uppal, S. Uppal
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Abstract

To review recent clinical evidence available for levetiracetam in the treatment of various types of epileptic seizures. A literature search was conducted to identify clinical studies conducted after 2015 with Levetiracetam. In patients with focal epilepsy, Levetiracetam was found to be as effective as Carbamazepine, Clobazam, and Valproic acid but with better tolerability than Carbamazepine. Levetiracetam could be used as monotherapy in the treatment of new-onset focal epilepsy. It probably has a neuroprotective benefit, particularly important in neonates and children. The safety and tolerability of Levetiracetam are more apparent during pregnancy. Thus, the adverse event profile is largely in favor of Levetiracetam in comparison to standard older AEDs. Meta-analysis has confirmed that Levetiracetam is significantly better in terms of withdrawal rates compared to the older AEDs, hence may be considered as the first line in new-onset focal epilepsy in adults and the elderly. Levetiracetam may be a better option as an add-on treatment in children with partial seizures, due to its favorable efficacy and insignificant toxicity than Oxcarbazepine and Topiramate. Recent evidence suggests that Levetiracetam could be a potential first-choice, second-line AED for Benzodiazepine resistance status epilepticus with efficacy comparable to established older AEDs. It improves the quality of life due to higher rates of seizure freedom and favorable tolerability profile. Levetiracetam has the potential for being a first-line AED and has also proven to be a better adjunctive considering the recent efficacy and safety outcomes.
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左乙拉西坦的最新情况
回顾最近关于左乙拉西坦治疗各种类型癫痫发作的临床证据。对2015年以后使用左乙拉西坦进行的临床研究进行文献检索。在局灶性癫痫患者中,左乙拉西坦与卡马西平、氯巴赞和丙戊酸一样有效,但耐受性优于卡马西平。左乙拉西坦可作为单药治疗新发局灶性癫痫。它可能有神经保护作用,对新生儿和儿童尤其重要。左乙拉西坦的安全性和耐受性在怀孕期间更为明显。因此,与标准的老式aed相比,左乙拉西坦的不良事件特征在很大程度上有利于左乙拉西坦。荟萃分析证实,左乙拉西坦在停药率方面明显优于老年AEDs,因此可以考虑作为治疗成人和老年人新发局性癫痫的一线药物。与奥卡西平和托吡酯相比,左乙拉西坦疗效好,毒性小,可能是部分性癫痫患儿更好的附加治疗选择。最近的证据表明,左乙拉西坦可能是治疗苯二氮卓类药物耐药癫痫持续状态的潜在首选二线AED,其疗效与已有的老年AED相当。由于较高的癫痫发作自由率和良好的耐受性,它提高了生活质量。考虑到最近的疗效和安全性结果,左乙拉西坦有潜力成为一线AED,也被证明是一种更好的辅助药物。
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