Abstract
In spite of substantial progress in epileptology, complete seizure control cannot be achieved in a considerable proportion of patients (about 30 %); in this regard, the synthesis of new antiepileptic drugs (AEDs) and rational combinations of available AEDs in view of their mechanisms of action remains relevant. Of particular interest are drugs with different mechanisms of action in relation to other AEDs (these drugs include levetiracetam, lacosamide, perampanel, etc.). The authors provide a literature review dealing with one of the new drugs – levetiracetam (Keppra) that has a different mechanism of action, as compared with other AEDs. Levetiracetam has been approved for use as initial monotherapy for partial-onset epilepsy with or without secondary generalization in patients who are at least 16 years of age, as adjunctive treatment of partial-onset seizures with and without secondary generalization in babies who are at least 1 month old (oral solution) or in children who are at least 6 years old (tablets), and in patients who are at least 12 years of age as adjunctive treatment of myoclonic seizures in juvenile myoclonic epilepsy and as therapy for generalized tonic-clonic seizures in idiopathic generalized epilepsy. The review details the mechanism of action of levetiracetam, its pharmacokinetics, and data on its efficacy and tolerability in the treatment of epilepsy. The findings have led to the conclusion that levetiracetam is a well-studied and promising drug used in the monoand polytherapy of different forms of epilepsy.
Highlights
In spite of substantial progress in epileptology, complete seizure control cannot be achieved in a considerable proportion of patients; in this regard, the synthesis of new antiepileptic drugs (AEDs) and rational combinations of available AEDs in view of their mechanisms of action remains relevant
The authors provide a literature review dealing with one of the new drugs – levetiracetam (Keppra) that has a different mechanism of action, as compared with other AEDs
Levetiracetam has been approved for use as initial monotherapy for partial-onset epilepsy with or without secondary generalization in patients who are at least 16 years of age, as adjunctive treatment of partial-onset seizures with and without secondary generalization in babies who are at least 1 month old or in children who are at least 6 years old, and in patients who are at least 12 years of age as adjunctive treatment of myoclonic seizures in juvenile myoclonic epilepsy and as therapy for generalized tonic-clonic seizures in idiopathic generalized epilepsy
Summary
Эффективность и переносимость леветирацетама (препарат Кеппра®) в лечении эпилепсии: обзор литературы. В этой группе есть препараты с особенным, отличным от других АЭП механизмом действия (например, леветирацетам, лакосамид, перампанел и др.), что позволяет воздействовать на различные звенья патогенеза эпилепсии и достигать высокой эффективности в отношении контроля над приступами. Леветирацетам одобрен в монотерапии для стартового лечения впервые выявленной парциальной эпилепсии у пациентов с 16 лет, с вторичной генерализацией или без нее; другие зарегистрированные показания к применению препарата включают: применение в дополнительной терапии парциальных приступов с вторичной генерализацией или без нее у детей с 1 месяца – для формы орального раствора и с 6 лет – для таблетированной формы; с 12 лет применение в дополнительной терапии миоклонических приступов при юношеской миоклонической эпилепсии (ЮМЭ), а также для лечения генерализованных тонико-клонических приступов при идиопатической генерализованной эпилепсии (ИГЭ) [64]. Новые рекомендации Международной противоэпилептической лиги (International League Against Epilepsy – ILAE) по инициальной монотерапии АЭП при различных типах эпилептических приступов и различных эпилептических синдромах [38]
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