Introduction

Brivaracetam (trade name: Briviact) has been approved in Germany since January 2016 as an add-on therapy for epileptic seizures in teenagers over the age of 16 and in adults. As of July 2018, it can now also be given to children as young as 4 years of age.

Epileptic seizures are triggered by abnormal activity in the nerve cells of the brain. Epileptic seizures can cause reduced consciousness, altered awareness and muscle twitching, as well as severe convulsions and discomfort. A seizure usually lasts between a few seconds and a few minutes.

Epileptic seizures are classified as either partial or generalized, depending on how much of the brain is affected. Generalized seizures affect the entire body. Partial (or focal) seizures only affect a small part of the brain, with muscle twitching or convulsions only occurring in certain parts of the body. Partial seizures can, however, spread across the whole body – this is called a “secondary generalization.”

Brivaracetam has been approved for the treatment of partial seizures with or without secondary generalization in people aged 16 years and over. The drug affects the production of neurotransmitters in the brain to prevent seizures.

Application

Brivaracetam is used in addition to standard treatment. The drug is available in the following forms:

  • Tablet (10, 25, 50, 75 or 100 mg)
  • Solution to be swallowed (10 mg)
  • Injection or infusion (10 mg): The drug can be injected into a vein or given as an infusion (IV drip).

In children and teenagers, the dosage will depend on their body weight. It is individually adjusted based on the severity of the seizures and the occurrence of side effects.

Other treatments

For people who have partial seizures, with and without secondary generalization, there are a number of add-on therapy options depending on the individual circumstances. The options include levetiracetam, valporic acid, gabapentin, lamotrigine and several other medications.

Assessment

In 2018, the Institute for Quality and Efficiency in Health Care (IQWiG, Germany) wanted to find out whether brivaracetam has any advantages or disadvantages compared with the current standard treatments for people aged 4 and over who have partial epileptic seizures.

But the manufacturer didn't provide any suitable data with which to do the assessment.

More information

This information summarizes the main results of several reviews produced by the Institute for Quality and Efficiency in Health Care (IQWiG, Germany). The reviews were commissioned by the German Federal Joint Committee (G-BA) as part of the “early benefit assessment of medications.” On the basis of the reviews and the hearings received, the G-BA passed a resolution on the added benefit of brivaracetam (Briviact).