López-González, F.J. (Francisco Javier)

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2016 - 20182

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    NEOPLASM study: Real-life use of lacosamide in patients with brain tumor-related epilepsy
    (Elsevier, 2016) Villanueva, V. (Vicente); Saiz-Díaz, R.A. (Rosa Ana); Toledo, M. (Manuel); Piera-Carbonell, A. (Ana); Mauri-Llerda, J.Á. (José Ángel); Rodríguez-Uranga, J.J. (J. J.); López-González, F.J. (Francisco Javier); Gomez-Ibañez, A. (Asier); Garcés, M. (Mercedes); González-de la Aleja, J. (Jesús); Rodríguez-Osorio, X. (Xiana); Palao-Duarte, S. (Susana); Castillo, A. (Ascensión); Bonet, M. (Macarena); Ruiz-Giménez, J. (Jesús); Palau, J. (Juan); Arcediano, A. (Alberto); Toledo, M. (María); Gago, A. (Ana)
    Background The choice of antiepileptic drug (AED) therapy in patients with brain tumor-related epilepsy (BTRE) is complicated, and there are a lack of robust clinical trial data to date. Methods The NEOPLASM (Neuroncologic Patients treated with LAcoSaMide) study was a 6-month, multicenter, retrospective, observational study in patients with BTRE treated with lacosamide. Patients were started on lacosamide because of a lack of efficacy or adverse events (AEs) with prior AEDs or suitability versus other AEDs, according to clinical practice. The primary efficacy variable was the seizure-free rate at 6 months. Safety variables included the proportion of patients with an AE and the proportion with an AE that led to discontinuation. Results Overall, 105 patients from 14 hospital centers were included in the analysis. Treatment with lacosamide for 6 months resulted in a 30.8% seizure-free rate, and 66.3% of patients had a ≥ 50% seizure reduction (responders). In the subset of patients included because of a lack of efficacy with prior AEDs, seizure-free rates were 28.0%, and 66.7% of patients were responders. No statistically significant differences in efficacy were observed according to the mechanism of action or enzyme-inducing properties of concomitant AEDs. Adverse events were reported by 41.9% of patients at 6 months, and 4.7% of them led to discontinuation. The most common AEs were somnolence/fatigue and dizziness. Notably, 57.1% of the patients who were switched to lacosamide because of AEs with their previous therapy did not report any AE at 6-month follow-up.
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    BRIVA-LIFE–A multicenter retrospective study of the long-term use of brivaracetam in clinical practice
    (Wiley Online Library, 2018) Villanueva, V. (Vicente); López-González, F.J. (Francisco Javier); Mauri-Llerda, J.Á. (José Ángel); Rodríguez-Uranga, J.J. (J. J.); Olivé-Gadea, M. (Marta); Montoya, J. (Javier); Ruiz-Giménez, J. (Jesús); Zurita, J. (Jorge)
    Objectives Evaluate long-term effectiveness and tolerability of brivaracetam in clinical practice in patients with focal epilepsy. Materials and Methods This was a multicenter retrospective study. Patients aged ≥16 years were started on brivaracetam from November 2016 to June 2017 and followed over 1 year. Data were obtained from medical records at 3, 6 and 12 months after treatment initiation for evaluation of safety- and seizure-related outcomes. Results A total of 575 patients were included in analyses; most had been treated with ≥4 lifetime antiepileptic drugs. Target dosage was achieved by 30.6% of patients on the first day. Analysis of primary variables at 12 months revealed that mean reduction in seizure frequency was 36.0%, 39.7% of patients were ≥50% responders and 17.5% were seizure-free. Seizure-freedom was achieved by 37.5% of patients aged ≥65 years. Incidence of adverse events (AEs) and psychiatric AEs (PAEs) was 39.8% and 14.3%, respectively, and discontinuation due to these was 8.9% and 3.7%, respectively. Somnolence, irritability, and dizziness were the most frequently reported AEs. At baseline, 228 (39.7%) patients were being treated with levetiracetam; most switched to brivaracetam (dose ratio 1:10-15). Among those who switched because of PAEs (n = 53), 9 (17%) reported PAEs on brivaracetam, and 3 (5.7%) discontinued because of PAEs. Tolerability was not highly affected among patients with learning disability or psychiatric comorbidity. Conclusions In a large population of patients with predominantly drug-resistant epilepsy, brivaracetam was effective and well-tolerated; no unexpected AEs occurred over 1 year, and the incidence of PAEs was lower compared with levetiracetam.