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Quality of life after switching to generic levetiracetam – A prospective comparative study

Olsson, Patrik LU ; Reimers, Arne LU and Kallen, Kristina LU (2019) In Epilepsy and Behavior 96. p.169-174
Abstract
Background

Improved quality of life (QoL) is one of the most important objectives in the treatment of epilepsy. Recent prospective, clinical studies proved no significant differences between brand antiepileptic drugs (AEDs) and their generic equivalents in terms of seizure control, pharmacokinetics, or safety. In this study, we focused on possible changes in QoL and adverse events in connection with generic substitution of levetiracetam (LEV).
Methods

This was a prospective, naturalistic, two-cohort, twin-center study. After a baseline period of 10 weeks, outpatients with epilepsy on stable treatment with Keppra® either continued on this brand (reference group, n = 16) or switched to generic LEV (1A Pharma®) (study... (More)
Background

Improved quality of life (QoL) is one of the most important objectives in the treatment of epilepsy. Recent prospective, clinical studies proved no significant differences between brand antiepileptic drugs (AEDs) and their generic equivalents in terms of seizure control, pharmacokinetics, or safety. In this study, we focused on possible changes in QoL and adverse events in connection with generic substitution of levetiracetam (LEV).
Methods

This was a prospective, naturalistic, two-cohort, twin-center study. After a baseline period of 10 weeks, outpatients with epilepsy on stable treatment with Keppra® either continued on this brand (reference group, n = 16) or switched to generic LEV (1A Pharma®) (study group, n = 16) for an eight-week study period. The Quality of Life in Epilepsy Inventory-31 (QOLIE-31) and an adverse events' questionnaire were administered at inclusion, after baseline, and at the end of the study period. The study protocol included a close clinical follow-up with repeated LEV serum concentration measurements and nurse-led outpatient visits.
Results

Clinically relevant improvements in overall QOLIE-31 scores according to minimally important change (MIC) estimates were seen in both groups. QOLIE-31 subscales in both groups showed significantly less worry about seizures at the end of the study compared to scores at inclusion (study group: p = 0.01; reference group: p = 0.02). No significant deterioration in QoL or adverse events were observed following generic substitution. No switchbacks occurred.
Conclusions

We found reduced seizure worries over time among people with epilepsy allocated to either generic switch or continued treatment with brand LEV. We hypothesize that the nurse-led structured follow-up had an impact on seizure worries and switchback rates because of reduced nocebo effects. Further studies on generic AED substitution, focusing on psychological outcome measures, are warranted to test this supposition. (Less)
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author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Epilepsy and Behavior
volume
96
pages
169 - 174
publisher
Elsevier
external identifiers
  • scopus:85066275347
  • pmid:31150996
ISSN
1525-5069
DOI
10.1016/j.yebeh.2019.04.029
language
English
LU publication?
yes
id
d04ea6f3-5b23-409e-a986-52651c7a197b
date added to LUP
2019-05-07 09:05:13
date last changed
2022-04-25 23:12:28
@article{d04ea6f3-5b23-409e-a986-52651c7a197b,
  abstract     = {{Background<br/><br/>Improved quality of life (QoL) is one of the most important objectives in the treatment of epilepsy. Recent prospective, clinical studies proved no significant differences between brand antiepileptic drugs (AEDs) and their generic equivalents in terms of seizure control, pharmacokinetics, or safety. In this study, we focused on possible changes in QoL and adverse events in connection with generic substitution of levetiracetam (LEV).<br/>Methods<br/><br/>This was a prospective, naturalistic, two-cohort, twin-center study. After a baseline period of 10 weeks, outpatients with epilepsy on stable treatment with Keppra® either continued on this brand (reference group, n = 16) or switched to generic LEV (1A Pharma®) (study group, n = 16) for an eight-week study period. The Quality of Life in Epilepsy Inventory-31 (QOLIE-31) and an adverse events' questionnaire were administered at inclusion, after baseline, and at the end of the study period. The study protocol included a close clinical follow-up with repeated LEV serum concentration measurements and nurse-led outpatient visits.<br/>Results<br/><br/>Clinically relevant improvements in overall QOLIE-31 scores according to minimally important change (MIC) estimates were seen in both groups. QOLIE-31 subscales in both groups showed significantly less worry about seizures at the end of the study compared to scores at inclusion (study group: p = 0.01; reference group: p = 0.02). No significant deterioration in QoL or adverse events were observed following generic substitution. No switchbacks occurred.<br/>Conclusions<br/><br/>We found reduced seizure worries over time among people with epilepsy allocated to either generic switch or continued treatment with brand LEV. We hypothesize that the nurse-led structured follow-up had an impact on seizure worries and switchback rates because of reduced nocebo effects. Further studies on generic AED substitution, focusing on psychological outcome measures, are warranted to test this supposition.}},
  author       = {{Olsson, Patrik and Reimers, Arne and Kallen, Kristina}},
  issn         = {{1525-5069}},
  language     = {{eng}},
  pages        = {{169--174}},
  publisher    = {{Elsevier}},
  series       = {{Epilepsy and Behavior}},
  title        = {{Quality of life after switching to generic levetiracetam – A prospective comparative study}},
  url          = {{http://dx.doi.org/10.1016/j.yebeh.2019.04.029}},
  doi          = {{10.1016/j.yebeh.2019.04.029}},
  volume       = {{96}},
  year         = {{2019}},
}