An initial experience with therapeutic drug monitoring of levetiracetam as reported from a pediatric clinical setting in India

作者：Mathew B S^*; Fleming D H; Thomas M; Prabha R; Saravanakumar K

来源：Neurology India, 2012, 60(2): 146-149.

DOI：10.4103/0028-3886.96382

• Co-medication
• concentration
• levetiracetam
• seizure control

Background and Objectives: Monitoring of levetiracetam in routine clinical practice is not strongly recommended. The aim of this study was to investigate any difference in serum levetiracetam concentration between patients on enzyme-inducing and -inhibiting antiepileptic co-medication and also to identify any correlation between levetiracetam concentration and clinical response. Materials and Methods: This study included pediatric patients with epilepsy from a tertiary care referral hospital in India. Details of antiepileptic co-medication, seizure frequency before and after initiating levetiracetam were recorded. Serum trough levetiracetam concentration was measured. Results: Of the 69 children recruited in the study, 55 children had >50% reduction in seizure frequency compared to baseline seizure frequency. Eight patients showed no improvement. The serum concentration of levetiracetam was more than 10 mu g/ml in 78.2% of responders and 75% non-responders. There was no difference in dosing between responders and non-responders. Patients on enzyme-inducing co-medication had lower median serum levetiracetam concentrations (7.3 mu g/ml) compared to those on enzyme-inhibiting co-medication (14.4 mu g/ml) or those without interfering antiepileptic co-medication (16.6 mu g/ml). Conclusion: Levetiracetam monitoring has a role in patients on antiepileptic polypharmacy and for confirmation of compliance.

• 出版日期2012-4