Peltola J et al. (2008) Once-daily extended-release levetiracetam as adjunctive treatment of partial-onset seizures in patients with epilepsy: a double-blind, randomized, placebo-controlled trial. Epilepsia [doi:10.1111/j.1528-1167.2008.01817.x]

Increased numbers of daily antiepileptic drug doses are associated with reduced treatment compliance among patients with epilepsy, which might impair seizure control. Peltola et al. investigated the safety and efficacy of extended-release levetiracetam (LEV XR), which need only be administered once daily, as adjunctive therapy in patients with partial-onset seizures (POSs).

This multicenter, double-blind trial examined patients aged 12–70 years with recurrent POS refractory to between one and three antiepileptic drugs. Seizure frequency was monitored for 8 weeks to determine baseline POS frequency. Participants were then randomly allocated to receive either two 500 mg tablets of LEV XR daily (n = 74) or two matching placebo tablets (n = 178) for 12 weeks, with concomitant antiepileptic treatment.

The median reduction from baseline in POS frequency was significantly greater in the LEV XR group than in the placebo group (46.07% vs 33.40% reduction, respectively). In total, 34 (43%) LEV XR patients and 23 (29%) placebo patients experienced a ≥50% reduction from baseline in weekly POS frequency, and 8 (10.1%) LEV XR patients and 1 (1.3%) placebo patient, were POS-free for the whole 12-week treatment period. Treatment-emergent and therapy-related adverse effects were similar in the two study groups.

The authors conclude that once-daily LEV XR significantly reduces POS frequency and is well tolerated in patients with seizures refractory to at least one antiepileptic drug.