{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:59:39Z","timestamp":1776214779163,"version":"3.50.1"},"reference-count":36,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,9,9]],"date-time":"2023-09-09T00:00:00Z","timestamp":1694217600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aimed to explore the effectiveness of brivaracetam (BRV) according to baseline seizure frequency and past treatment history in subjects with focal epilepsy who were included in the Brivaracetam Add\u2010On First Italian Network Study (BRIVAFIRST).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>BRIVAFIRST was a 12\u2010month retrospective, multicenter study including adults prescribed adjunctive BRV. Study outcomes included sustained seizure response (SSR), sustained seizure freedom (SSF), and the rates of treatment discontinuation and adverse events (AEs). Baseline seizure frequency was stratified as &lt;5, 5\u201320, and &gt;20 seizures per month, and the number of prior antiseizure medications (ASMs) as &lt;5 and \u22656.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 994 participants were included. During the 1\u2010year study period, SSR was reached by 45.8%, 39.3%, and 22.6% of subjects with a baseline frequency of &lt;5, 5\u201320, and &gt;20 seizures per month (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001); the corresponding figures for the SSF were 23.4%, 9.8%, and 2.8% (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). SSR was reached by 51.2% and 26.5% participants with a history of 1\u20135 and \u22656 ASMs (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001); the corresponding rates of SSF were 24.7% and 4.5% (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). Treatment discontinuation due to lack of efficacy was more common in participants with &gt;20 seizures compared to those with &lt;5 seizures per month (25.8% vs. 9.3%, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001), and in participants with history of \u22656 prior ASMs compared to those with history of 1\u20135 ASMs (19.6% vs. 12.2%, <jats:italic>p<\/jats:italic>\u2009=\u2009.002). There were no differences in the rates of BRV withdrawal due to AEs and the rates of AEs across the groups of participants defined according to the number of seizures at baseline and the number of prior ASMs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>The baseline seizure frequency and the number of previous ASMs were predictors of sustained seizure frequency reduction with adjunctive BRV in subjects with focal epilepsy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.17740","type":"journal-article","created":{"date-parts":[[2023,8,7]],"date-time":"2023-08-07T03:49:15Z","timestamp":1691380155000},"page":"2922-2933","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Adjunctive brivaracetam and sustained seizure frequency reduction in very active focal epilepsy"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8748-0083","authenticated-orcid":false,"given":"Simona","family":"Lattanzi","sequence":"first","affiliation":[{"name":"Neurological Clinic, Department of Experimental and Clinical Medicine Marche Polytechnic University  Ancona Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5385-761X","authenticated-orcid":false,"given":"Laura","family":"Canafoglia","sequence":"additional","affiliation":[{"name":"Department of Epileptology Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Paola","family":"Canevini","sequence":"additional","affiliation":[{"name":"Epilepsy Center, Child Neuropsychiatry Unit, AAST Santi Paolo Carlo  Milan Italy"},{"name":"Department of Health Sciences Universit\u00e0 degli Studi  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Casciato","sequence":"additional","affiliation":[{"name":"IRCCS Neuromed  Pozzilli Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emanuele","family":"Cerulli\u00a0Irelli","sequence":"additional","affiliation":[{"name":"Department of Human Neurosciences, Policlinico Umberto I Sapienza University of Rome  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentina","family":"Chiesa","sequence":"additional","affiliation":[{"name":"Epilepsy Center, Child Neuropsychiatry Unit, AAST Santi Paolo Carlo  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filippo","family":"Dainese","sequence":"additional","affiliation":[{"name":"Epilepsy Center, Neurology Unit  Venice Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"De\u00a0Maria","sequence":"additional","affiliation":[{"name":"Clinical Neurophysiology Unit, Epilepsy Center, Spedali Civili  Brescia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4812-6310","authenticated-orcid":false,"given":"Giuseppe","family":"Didato","sequence":"additional","affiliation":[{"name":"Epilepsy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giancarlo","family":"Di\u00a0Gennaro","sequence":"additional","affiliation":[{"name":"IRCCS Neuromed  Pozzilli Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0745-5246","authenticated-orcid":false,"given":"Giovanni","family":"Falcicchio","sequence":"additional","affiliation":[{"name":"Department of Basic Medical Sciences Neurosciences and Sense Organs, University Hospital of Bari A. Moro  Bari Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martina","family":"Fanella","sequence":"additional","affiliation":[{"name":"Department of Human Neurosciences, Policlinico Umberto I Sapienza University of Rome  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edoardo","family":"Ferlazzo","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences Magna Gr\u00e6cia University of Catanzaro  Catanzaro Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimo","family":"Gangitano","sequence":"additional","affiliation":[{"name":"Department of Biomedicine, Neuroscience, and Advanced Diagnostics University of Palermo  Palermo Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela","family":"La\u00a0Neve","sequence":"additional","affiliation":[{"name":"Department of Basic Medical Sciences Neurosciences and Sense Organs, University Hospital of Bari A. 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