Safety of levetiracetam among infants younger than 12 months

Background: There are limited data on the use of the antiepileptic drug (AED) levetiracetam for the treatment of infants. Aim: To prospectively evaluate the safety of levetiracetam oral solution and its impact on epilepsy severity in infants with different seizure types. 

Methods: This noninterventional post-authorization safety study included patients 1e11 months of age. Patients' treatment e levetiracetam dose, and addition, withdrawal or changes in the doses of concomitant medications and AEDs e was at the discretion of the physician. The primary variable was treatment-emergent adverse events (TEAEs).

Results: Of 101 infants, 75 completed and 26 discontinued the study. Mean age was 6.0 months, 50 were male, most (80%) took 1  concomitant AED and had cryptogenic or symptomatic epilepsy that was focal (38.6%) or generalized (20.8%), particularly frontal lobe epilepsy (20.0%) or West syndrome/infantile spasms (20.0%). Among known aetiologies, congenital factors (22.8%) such as dysplastic lesions or perinatal events (17.8%) were predominant. Overall, 54.5% of patients had 1 TEAE. Five patients experienced drug-related TEAEs e convulsion, irritability, somnolence and hypotonia, all listed in the product label, with the exception of hypotonia, which was reported for one patient and resolved without any change in study medication. Seven patients discontinued due to TEAEs, mainly due to infantile spasms and respiratory disorders. At study end, 71.8% of patients showed improvement in epilepsy severity, 18.8% remained stable and 9.4% showed worsening. Levetiracetam did not appear to have a negative effect on growth parameters.

Conclusion: In this prospective study, which included the largest number of patients in this age range so far, levetiracetam was found to be well tolerated and efficacious for the treatment of infants with epilepsy.