LONG-TERM EFFECTIVENESS OF LEVETIRACETAM MONOTHERAPY IN ADULT PATIENT WITH EPILEPSY: A 10-YEAR SINGLE-COHORT SURVIVAL ANALYSIS
Author(s)
Waad H. Alkathiri, MSc, PhD candidate1, Bander Balkhi, PharmD, PhD1, Saeed Alqahtani, PharmD, PhD2, Abdlatif A H. Alghaiheb, PhD1.
1King Saud University, Riyadh, Saudi Arabia, 2College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.
1King Saud University, Riyadh, Saudi Arabia, 2College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.
OBJECTIVES: To estimate the effectiveness of Levetiracetam and to define the baseline characteristics of poor responders to Levetiracetam monotherapy in patients with epilepsy.
METHODS: A retrospective cohort study was conducted among 769 adult patients with epilepsy at a tertiary hospital in Saudi Arabia who initiated levetiracetam as monotherapy between 2015 and 2024. The index date was defined as the date of levetiracetam initiation. Patients were followed from the index date until treatment failure or censoring. Treatment failure was defined as either discontinuation of levetiracetam due to an adverse event or the addition of another anticonvulsant drug to the treatment plan duo to poor seizure control. Patients were censored if they did not experience treatment failure, were lost to follow-up, or reached the study end. Time-to-event analyses were performed using the Kaplan-Meier method to estimate the cumulative probability of Levetiracetam effectiveness over follow-up, defined as remaining free of the treatment failure event, with 95% confidence intervals. Patient characteristics were compared between patients with and without treatment failure using Student’s t-test for continuous variables and chi-square test or Fisher’s exact test for Categorical variables.
RESULTS: Among 769 patients initiating Levetiracetam monotherapy, 143 (18.55%) experienced treatment failure during a 10-year follow-up. The overall mean time to Levetiracetam treatment failure was 93.58 months. The 25th percentile time to Levetiracetam treatment failure was 95 months (%95 CI: 60.167 - 103.133). The median survival time was not reached. Patients in the treatment-failure group were younger (39.85 ±16.88 vs 45.76 ±19.48, P 0.0003), received higher doses (70.63 % vs 49.93, p <0.0001), and had a different distribution of Epilepsy types (Generalized 40.56 % vs 33.71 %, Focal 25.87% vs 19.81%, unclassified 33.57% vs 46.49%, p 0.0182) compared with the treatment-success group.
CONCLUSIONS: Levetiracetam monotherapy demonstrated sustained long-term effectiveness as a first-line therapy in adult patients with epilepsy.
METHODS: A retrospective cohort study was conducted among 769 adult patients with epilepsy at a tertiary hospital in Saudi Arabia who initiated levetiracetam as monotherapy between 2015 and 2024. The index date was defined as the date of levetiracetam initiation. Patients were followed from the index date until treatment failure or censoring. Treatment failure was defined as either discontinuation of levetiracetam due to an adverse event or the addition of another anticonvulsant drug to the treatment plan duo to poor seizure control. Patients were censored if they did not experience treatment failure, were lost to follow-up, or reached the study end. Time-to-event analyses were performed using the Kaplan-Meier method to estimate the cumulative probability of Levetiracetam effectiveness over follow-up, defined as remaining free of the treatment failure event, with 95% confidence intervals. Patient characteristics were compared between patients with and without treatment failure using Student’s t-test for continuous variables and chi-square test or Fisher’s exact test for Categorical variables.
RESULTS: Among 769 patients initiating Levetiracetam monotherapy, 143 (18.55%) experienced treatment failure during a 10-year follow-up. The overall mean time to Levetiracetam treatment failure was 93.58 months. The 25th percentile time to Levetiracetam treatment failure was 95 months (%95 CI: 60.167 - 103.133). The median survival time was not reached. Patients in the treatment-failure group were younger (39.85 ±16.88 vs 45.76 ±19.48, P 0.0003), received higher doses (70.63 % vs 49.93, p <0.0001), and had a different distribution of Epilepsy types (Generalized 40.56 % vs 33.71 %, Focal 25.87% vs 19.81%, unclassified 33.57% vs 46.49%, p 0.0182) compared with the treatment-success group.
CONCLUSIONS: Levetiracetam monotherapy demonstrated sustained long-term effectiveness as a first-line therapy in adult patients with epilepsy.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
CO60
Topic
Clinical Outcomes, Epidemiology & Public Health, Real World Data & Information Systems
Topic Subcategory
Relating Intermediate to Long-term Outcomes
Disease
Neurological Disorders