Brivaracetam and topiramate serum levels during pregnancy and delivery: a case report and a review of literature.

Q2 Medicine Neurological research and practice Pub Date : 2024-03-21 DOI:10.1186/s42466-024-00312-9

Wiebke Hahn, Leona Möller, Katja Menzler, Tobias Poeplau, Uwe Wagner, Susanne Knake

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Abstract

Background: An increasing use of newer antiseizure medication (ASM) such as SV2A ligand brivaracetam is observed. However, data on newer antiseizure medication and therapeutic drug monitoring during pregnancy is scarce.

Methods: Therapeutic drug monitoring of brivaracetam (BRV) and topiramate (TPM) serum levels were performed during pregnancy, delivery and in the umbilical cord blood at delivery in a 34-year-old female patient with severe drug-resistant epilepsy.

Results: During pregnancy, the serum levels of brivaracetam and topiramate remained stable. At 39th week of pregnancy, the patient gave birth to a healthy daughter. 1.5 h after the last ASM intake, the penetration rate measured in umbilical cord blood was 45% lower for BRV and 35% lower for TPM.

Conclusions: While the pharmacokinetics of topiramate are well known and its use during pregnancy should only be undertaken under special circumstances, there have been few studies on newer ASM in pregnancy such as brivaracetam. Based on our results and other case reports of BRV use during pregnancy, further studies are necessary to confirm its pharmacokinetics and safety during pregnancy.

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妊娠和分娩期间血清中的 Brivaracetam 和 Topiramate 水平：病例报告和文献综述。

背景：新型抗癫痫药物（ASM）（如 SV2A 配体 brivaracetam）的使用日益增多。然而，有关新型抗癫痫药物和孕期治疗药物监测的数据却很少：方法：对一名 34 岁的女性重度耐药性癫痫患者在妊娠期、分娩期和分娩时脐带血中的布瓦西坦（Brivaracetam，BRV）和托吡酯（Topiramate，TPM）血清水平进行了治疗药物监测：结果：妊娠期间，血清中的布伐他坦和托吡酯水平保持稳定。怀孕第 39 周时，患者生下了一个健康的女儿。在最后一次摄入 ASM 1.5 小时后，在脐带血中测得的渗透率，BRV 降低了 45%，TPM 降低了 35%：尽管托吡酯的药代动力学已广为人知，而且只有在特殊情况下才能在妊娠期使用该药，但有关妊娠期使用新型 ASM（如布利瓦西坦）的研究却很少。根据我们的研究结果和其他关于妊娠期使用 BRV 的病例报告，有必要开展进一步研究，以确认其在妊娠期的药代动力学和安全性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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