Levetiracetam Therapeutic Drug Monitoring in a Large Cohort of Korean Epileptic Patients
Levetiracetam is a new antiepileptic drug (AED) used for treating and preventing partial or generalized seizures. The usefulness of levetiracetam therapeutic drug monitoring (TDM) is related to inter- or intra-individual pharmacokinetic variability, drug interactions, and patient noncompliance. We a...
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doaj-0ea795c1fd4349d09ec2b7c4b77554d42021-08-26T14:12:33ZengMDPI AGPharmaceuticals1424-82472021-08-011482682610.3390/ph14080826Levetiracetam Therapeutic Drug Monitoring in a Large Cohort of Korean Epileptic PatientsChanghee Ha0Hyun-Seung Lee1Eun Yeon Joo2Young-Min Shon3Seung Bong Hong4Dae-Won Seo5Soo-Youn Lee6Samsung Medical Center, Department of Laboratory Medicine and Genetics, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, KoreaSamsung Medical Center, Department of Laboratory Medicine and Genetics, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, KoreaNeuroscience Center, Samsung Medical Center, Department of Neurology, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, KoreaNeuroscience Center, Samsung Medical Center, Department of Neurology, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, KoreaNeuroscience Center, Samsung Medical Center, Department of Neurology, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, KoreaNeuroscience Center, Samsung Medical Center, Department of Neurology, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, KoreaSamsung Medical Center, Department of Laboratory Medicine and Genetics, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, KoreaLevetiracetam is a new antiepileptic drug (AED) used for treating and preventing partial or generalized seizures. The usefulness of levetiracetam therapeutic drug monitoring (TDM) is related to inter- or intra-individual pharmacokinetic variability, drug interactions, and patient noncompliance. We aimed to investigate the levetiracetam TDM status in Korean epilepsy patients. Serum trough levetiracetam concentrations were measured using liquid chromatography–tandem mass spectrometry in 710 samples from 550 patients. The median (range) daily and weight-adjusted levetiracetam doses were 1500 (20–5000) mg and 25.5 (3.03–133.0) mg/kg, respectively. Patients on levetiracetam monotherapy constituted only 19.5% of the population, while 30.1% were on co-medication with valproate and 56.0% with enzyme-inducing AEDs (EIAEDs). Observed levetiracetam concentrations were widely distributed, ranging 0.8–95 mg/L, with a median of 17.3 mg/L. Levetiracetam concentrations were therapeutic, supra-therapeutic, and sub-therapeutic in 58.5% (<i>n</i> = 393), 11.6% (<i>n</i> = 78), and 29.9% (<i>n</i> = 201) of samples, respectively. There was a strong correlation between weight-adjusted levetiracetam dosage and concentrations (<i>ρ</i> = 0.6896, <i>p</i> < 0.0001). In this large-scale clinical study, a large inter-individual difference in levetiracetam pharmacokinetics was observed, and levetiracetam concentrations were influenced by EIAEDs. For individual dose adjustments and monitoring compliance, routine levetiracetam TDM is needed in epilepsy patients.https://www.mdpi.com/1424-8247/14/8/826therapeutic drug monitoringdrug–drug interactionantiepileptic drugsepilepsylevetiracetampharmacokinetics |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Changhee Ha Hyun-Seung Lee Eun Yeon Joo Young-Min Shon Seung Bong Hong Dae-Won Seo Soo-Youn Lee |
spellingShingle |
Changhee Ha Hyun-Seung Lee Eun Yeon Joo Young-Min Shon Seung Bong Hong Dae-Won Seo Soo-Youn Lee Levetiracetam Therapeutic Drug Monitoring in a Large Cohort of Korean Epileptic Patients Pharmaceuticals therapeutic drug monitoring drug–drug interaction antiepileptic drugs epilepsy levetiracetam pharmacokinetics |
author_facet |
Changhee Ha Hyun-Seung Lee Eun Yeon Joo Young-Min Shon Seung Bong Hong Dae-Won Seo Soo-Youn Lee |
author_sort |
Changhee Ha |
title |
Levetiracetam Therapeutic Drug Monitoring in a Large Cohort of Korean Epileptic Patients |
title_short |
Levetiracetam Therapeutic Drug Monitoring in a Large Cohort of Korean Epileptic Patients |
title_full |
Levetiracetam Therapeutic Drug Monitoring in a Large Cohort of Korean Epileptic Patients |
title_fullStr |
Levetiracetam Therapeutic Drug Monitoring in a Large Cohort of Korean Epileptic Patients |
title_full_unstemmed |
Levetiracetam Therapeutic Drug Monitoring in a Large Cohort of Korean Epileptic Patients |
title_sort |
levetiracetam therapeutic drug monitoring in a large cohort of korean epileptic patients |
publisher |
MDPI AG |
series |
Pharmaceuticals |
issn |
1424-8247 |
publishDate |
2021-08-01 |
description |
Levetiracetam is a new antiepileptic drug (AED) used for treating and preventing partial or generalized seizures. The usefulness of levetiracetam therapeutic drug monitoring (TDM) is related to inter- or intra-individual pharmacokinetic variability, drug interactions, and patient noncompliance. We aimed to investigate the levetiracetam TDM status in Korean epilepsy patients. Serum trough levetiracetam concentrations were measured using liquid chromatography–tandem mass spectrometry in 710 samples from 550 patients. The median (range) daily and weight-adjusted levetiracetam doses were 1500 (20–5000) mg and 25.5 (3.03–133.0) mg/kg, respectively. Patients on levetiracetam monotherapy constituted only 19.5% of the population, while 30.1% were on co-medication with valproate and 56.0% with enzyme-inducing AEDs (EIAEDs). Observed levetiracetam concentrations were widely distributed, ranging 0.8–95 mg/L, with a median of 17.3 mg/L. Levetiracetam concentrations were therapeutic, supra-therapeutic, and sub-therapeutic in 58.5% (<i>n</i> = 393), 11.6% (<i>n</i> = 78), and 29.9% (<i>n</i> = 201) of samples, respectively. There was a strong correlation between weight-adjusted levetiracetam dosage and concentrations (<i>ρ</i> = 0.6896, <i>p</i> < 0.0001). In this large-scale clinical study, a large inter-individual difference in levetiracetam pharmacokinetics was observed, and levetiracetam concentrations were influenced by EIAEDs. For individual dose adjustments and monitoring compliance, routine levetiracetam TDM is needed in epilepsy patients. |
topic |
therapeutic drug monitoring drug–drug interaction antiepileptic drugs epilepsy levetiracetam pharmacokinetics |
url |
https://www.mdpi.com/1424-8247/14/8/826 |
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