Clinical features of long-term low-dose levetiracetam treatment for epilepsy.
BACKGROUND
The aim of this study was to assess the rate of response to long-term low-dose levetiracetam (LEV) treatment and the clinical factors associated with response.


METHODS
The response to low-dose LEV of 43 patients with epilepsy (22 male, 21 female; age range, 5-39 years; median age, 13 years) was retrospectively assessed. Patients aged <15 years received <20 mg/kg/day LEV, whereas those aged ≥15 years received <1000 mg/day LEV. Clinical features were compared between responders to low-dose LEV, responders to the recommended dose, and non-responders.


RESULTS
Of the 43 patients who received low-dose LEV, 13 (30%) showed improvement, defined as seizure cessation or >75% seizure reduction over 6 months for patients with monthly, weekly, and daily seizures; and over 1 year for patients with yearly seizures. Efficacy was maintained for >1 year in 10 (77%) of the 13 patients. Long-term response to low-dose LEV was significantly associated with older age at onset and fewer previous treatments with ineffective anti-epileptic drugs. All patients showing long-term response to low-dose LEV developed only focal seizures.


CONCLUSIONS
Titration of LEV starting from a low dose may be effective in selected patients. Once patients respond to low-dose treatment, maintenance of the effective dosage may prolong response.
['Yoshikawa|Sosuke|S|', 'Shimakawa|Shuichi|S|', 'Fukui|Miho|M|', 'Nomura|Shohei|S|', 'Tanabe|Takuya|T|', 'Tamai|Hiroshi|H|']
D000293:Adolescent D000328:Adult D000927:Anticonvulsants D002648:Child D002675:Child, Preschool D004305:Dose-Response Relationship, Drug D004827:Epilepsy D005260:Female D005500:Follow-Up Studies D006801:Humans D000077287:Levetiracetam D008297:Male D010889:Piracetam D012189:Retrospective Studies D013997:Time Factors D016896:Treatment Outcome D055815:Young Adult
levetiracetam epilepsy titration low-dose treatment long-term treatment