Brivaracetam
證據等級: L5 | 預測適應症: 10 個
## 藥師評估報告
Brivaracetam：從局部癲癇到視覺性癲癇
一句話總結
Brivaracetam 原為治療局部癲癇發作的第三代抗癲癇藥物，TxGNN 預測其可能對視覺性癲癇(visual epilepsy)有治療潛力。
快速總覽
| 項目 | 內容 | |------|------| | 原適應症 | 1個月大以上局部癲癇發作病人的治療 | | 預測新適應症 | visual epilepsy、status epilepticus、partial epilepsy、eating seizures、orgasm-induced seizures、thinking seizures、startle epilepsy、micturation-induced seizures、audiogenic seizures、beta-ketothiolase deficiency | | TxGNN 預測分數 | 99.51% | | 證據等級 | L3 (觀察性研究/光敏感性研究) | | 台灣上市 | 已上市 | | 許可證數 | 3張 | | 建議決策 | Proceed |
預測適應症詳細分析
1. visual epilepsy L4 99.51% 主要分析
為什麼這個預測合理？
Brivaracetam 是 levetiracetam 的結構類似物，具有獨特的作用機轉：
- SV2A 高親和力結合：brivaracetam 對突觸囊泡蛋白 2A (SV2A) 的親和力是 levetiracetam 的 15-30 倍
- 快速腦部穿透：高脂溶性使其能快速進入中樞神經系統
- 光敏感性癲癇研究：已有臨床研究證實 brivaracetam 能抑制光刺激誘發的腦電圖異常反應 (PPR)
- 廣譜抗癲癇活性：前臨床研究顯示對多種癲癇模型有效
視覺性癲癇與光敏感性癲癇相關，brivaracetam 在此領域已有初步臨床證據支持。
臨床試驗
目前無針對此特定適應症的臨床試驗登記。
相關文獻
| PMID | 年份 | 類型 | 期刊 | 主要發現 |
|---|---|---|---|---|
| 37684052 | 2023 | Article | BMJ (Clinical research ed.) | Management of epilepsy during pregnancy and lactation. |
| 38811492 | 2024 | Article | Advances in therapy | Narrative Review of Brivaracetam: Preclinical Profile and Clinical Benefits in t... |
| 38117319 | 2024 | Article | Intensive care medicine | Status epilepticus in the ICU. |
| 31033711 | 2019 | Article | JAAPA : official journal of th | Brivaracetam for epilepsy. |
| 38576178 | 2024 | Article | Epilepsia open | Efficacy, safety, and tolerability of adjunctive brivaracetam in adult Asian pat... |
| 36218253 | 2022 | Article | Revista de neurologia | [Paediatric status epilepticus]. |
| 32120063 | 2020 | Article | Neuropharmacology | Mechanisms of action of currently used antiseizure drugs. |
| 26760311 | 2016 | Article | Expert opinion on pharmacother | Brivaracetam for the treatment of epilepsy. |
| 37350392 | 2023 | Article | Epilepsia | Diagnosing nonconvulsive status epilepticus: Defining electroencephalographic an... |
| 31195850 | 2019 | Article | Expert review of neurotherapeu | Brivaracetam efficacy and safety in focal epilepsy. |
| 33479851 | 2021 | Article | CNS drugs | Expanding the Treatment Landscape for Lennox-Gastaut Syndrome: Current and Futur... |
| 21682662 | 2011 | Article | Expert opinion on pharmacother | Brivaracetam for the treatment of epilepsy. |
| 32822230 | 2020 | Article | Epilepsy currents | Treatment of Refractory Convulsive Status Epilepticus: A Comprehensive Review by... |
| 35285519 | 2022 | Article | The Cochrane database of syste | Brivaracetam add-on therapy for drug-resistant epilepsy. |
| 37483441 | 2023 | Article | Frontiers in neurology | Safety and efficacy of brivaracetam in children epilepsy: a systematic review an... |
| 31937513 | 2020 | Article | Epilepsy & behavior : E&B | Safety and tolerability of adjunctive brivaracetam in epilepsy: In-depth pooled ... |
| 36842341 | 2023 | Article | Journal of the neurological sc | Epilepsy and brain tumors: Two sides of the same coin. |
| 32966640 | 2021 | Article | Acta neurologica Scandinavica | Potential role of brivaracetam in pediatric epilepsy. |
2. status epilepticus L3 99.40%
臨床試驗（1 項）
| 試驗編號 | 階段 | 狀態 | 人數 | 主要發現 |
|---|---|---|---|---|
| NCT07163572 | NA | COMPLETED | 152 | Safety and Efficacy of Intravenous Brivaracetam Versus Levetiracetam in the Mana... |
相關文獻（19 篇）
| PMID | 年份 | 類型 | 期刊 | 主要發現 |
|---|---|---|---|---|
| 38117319 | 2024 | Article | Intensive care medicine | Status epilepticus in the ICU. |
| 32278203 | 2020 | Article | Journal of the neurological sc | Efficacy and tolerability of intravenous brivaracetam for status epilepticus: A ... |
| 37350392 | 2023 | Article | Epilepsia | Diagnosing nonconvulsive status epilepticus: Defining electroencephalographic an... |
| 36218253 | 2022 | Article | Revista de neurologia | [Paediatric status epilepticus]. |
| 39899098 | 2025 | Article | Continuum (Minneapolis, Minn.) | First Seizures, Acute Repetitive Seizures, and Status Epilepticus. |
| 32822230 | 2020 | Article | Epilepsy currents | Treatment of Refractory Convulsive Status Epilepticus: A Comprehensive Review by... |
| 26891946 | 2016 | Article | Expert review of clinical phar | Brivaracetam in the treatment of focal and idiopathic generalized epilepsies and... |
| 31264486 | 2019 | Article | Expert opinion on pharmacother | Recent advances in the pharmacotherapy of epilepsy: brivaracetam and perampanel ... |
| 30530123 | 2019 | Article | Epilepsy research | Intravenous brivaracetam in status epilepticus: Correlation between loading dose... |
| 32480279 | 2020 | Article | Seizure | Brivaracetam in absence status epilepticus. |
| 30473267 | 2019 | Article | Seizure | Novel drugs and early polypharmacotherapy in status epilepticus. |
| 31342405 | 2019 | Article | CNS drugs | Intravenous Brivaracetam in the Treatment of Status Epilepticus: A Systematic Re... |
| 19941524 | 2009 | Article | Epilepsia | What is the promise of new antiepileptic drugs in status epilepticus? Focus on b... |
| 36528008 | 2023 | Article | Epilepsy & behavior : E&B | Brivaracetam or levetiracetam in status epilepticus?: Lessons from the photosens... |
| 37839249 | 2023 | Article | Epilepsy & behavior : E&B | The real-world effectiveness of intravenous brivaracetam as a second-line treatm... |
| 33561784 | 2021 | Article | Seizure | Intravenous brivaracetam in status epilepticus: A multicentric retrospective stu... |
| 31260101 | 2019 | Article | Epilepsia | Use of intravenous brivaracetam in status epilepticus: A multicenter registry. |
| 28427029 | 2017 | Article | Epilepsy & behavior : E&B | Treatment of refractory and super-refractory status epilepticus with brivaraceta... |
| 30043427 | 2018 | Article | Epilepsia | Intravenous brivaracetam in status epilepticus: A retrospective single-center st... |
3. eating seizures L5 99.19%
目前尚無針對此適應症的專門臨床研究。此為 TxGNN 模型預測結果，需進一步驗證。
4. orgasm-induced seizures L5 99.19%
目前尚無針對此適應症的專門臨床研究。此為 TxGNN 模型預測結果，需進一步驗證。
5. thinking seizures L4 99.19%
相關文獻（1 篇）
| PMID | 年份 | 類型 | 期刊 | 主要發現 |
|---|---|---|---|---|
| 38558319 | 2024 | Article | Neurological sciences : offici | Brivaracetam use in clinical practice: a Delphi consensus on its role as first a... |
6. startle epilepsy L5 99.19%
目前尚無針對此適應症的專門臨床研究。此為 TxGNN 模型預測結果，需進一步驗證。
7. micturation-induced seizures L4 99.19%
相關文獻（18 篇）
| PMID | 年份 | 類型 | 期刊 | 主要發現 |
|---|---|---|---|---|
| 38117319 | 2024 | Article | Intensive care medicine | Status epilepticus in the ICU. |
| 38576178 | 2024 | Article | Epilepsia open | Efficacy, safety, and tolerability of adjunctive brivaracetam in adult Asian pat... |
| 39899098 | 2025 | Article | Continuum (Minneapolis, Minn.) | First Seizures, Acute Repetitive Seizures, and Status Epilepticus. |
| 36218253 | 2022 | Article | Revista de neurologia | [Paediatric status epilepticus]. |
| 37684052 | 2023 | Article | BMJ (Clinical research ed.) | Management of epilepsy during pregnancy and lactation. |
| 35861924 | 2022 | Article | CNS drugs | Antiseizure Drugs and Movement Disorders. |
| 36194365 | 2022 | Article | CNS drugs | Psychobehavioural and Cognitive Adverse Events of Anti-Seizure Medications for t... |
| 33839453 | 2021 | Article | Epilepsy & behavior : E&B | Behavioral adverse events with brivaracetam, levetiracetam, perampanel, and topi... |
| 33479851 | 2021 | Article | CNS drugs | Expanding the Treatment Landscape for Lennox-Gastaut Syndrome: Current and Futur... |
| 32120063 | 2020 | Article | Neuropharmacology | Mechanisms of action of currently used antiseizure drugs. |
| 38811492 | 2024 | Article | Advances in therapy | Narrative Review of Brivaracetam: Preclinical Profile and Clinical Benefits in t... |
| 37350392 | 2023 | Article | Epilepsia | Diagnosing nonconvulsive status epilepticus: Defining electroencephalographic an... |
| 32822230 | 2020 | Article | Epilepsy currents | Treatment of Refractory Convulsive Status Epilepticus: A Comprehensive Review by... |
| 35061214 | 2022 | Article | Drugs | Third-Generation Antiseizure Medications for Adjunctive Treatment of Focal-Onset... |
| 38643679 | 2024 | Article | Seizure | A comparison of cenobamate with other newer antiseizure medications for adjuncti... |
| 31603844 | 2019 | Article | Medicina | [New antiepileptic drugs]. |
| 39948216 | 2025 | Article | European journal of clinical p | Adjunctive treatment for pediatric focal epilepsy: a systematic review. |
| 31033711 | 2019 | Article | JAAPA : official journal of th | Brivaracetam for epilepsy. |
8. audiogenic seizures L4 99.19%
相關文獻（9 篇）
| PMID | 年份 | 類型 | 期刊 | 主要發現 |
|---|---|---|---|---|
| 18500360 | 2008 | Article | British journal of pharmacolog | Anti-convulsive and anti-epileptic properties of brivaracetam (ucb 34714), a hig... |
| 21575627 | 2011 | Article | European journal of pharmacolo | Binding characteristics of brivaracetam, a selective, high affinity SV2A ligand ... |
| 26663401 | 2016 | Article | Epilepsia | Brivaracetam, a selective high-affinity synaptic vesicle protein 2A (SV2A) ligan... |
| 39827675 | 2025 | Article | Epilepsy & behavior : E&B | A multicenter Phase II randomized, placebo-controlled single-blind trial with th... |
| 20102365 | 2010 | Article | Basic & clinical pharmacology | Physiologically based pharmacokinetic/pharmacodynamic animal-to-man prediction o... |
| 17785672 | 2007 | Article | Neurology | Evaluation of brivaracetam, a novel SV2A ligand, in the photosensitivity model. |
| 18552880 | 2008 | Article | British journal of pharmacolog | Brivaracetam: a rational drug discovery success story. |
| 32949370 | 2020 | Article | CNS drugs | Rapidity of CNS Effect on Photoparoxysmal Response for Brivaracetam vs. Levetira... |
| 14736235 | 2004 | Article | Journal of medicinal chemistry | Discovery of 4-substituted pyrrolidone butanamides as new agents with significan... |
9. beta-ketothiolase deficiency L5 99.14%
目前尚無針對此適應症的專門臨床研究。此為 TxGNN 模型預測結果，需進一步驗證。
10. adolescent/adult onset autosomal dominant epilepsy with auditory features L5 99.10%
目前尚無針對此適應症的專門臨床研究。此為 TxGNN 模型預測結果，需進一步驗證。
台灣上市資訊
Brivaracetam 在台灣的藥品許可證：
| 許可證字號 | 商品名 | 劑型 | 許可證持有者 |
|---|---|---|---|
| 衛部藥輸字第027714號 | 必治癲膜衣錠 10mg | 膜衣錠 | 台灣優時比貿易有限公司 |
| 衛部藥輸字第027714號 | 必治癲膜衣錠 25mg | 膜衣錠 | 台灣優時比貿易有限公司 |
| 衛部藥陸輸字第001179號 | 丁醯胺吡咯酮(原料藥) | 粉末 | 丞泰企業有限公司 |
核准適應症：適用於1個月大以上局部癲癇發作病人的治療
安全性考量
常見副作用
- 嗜睡、頭暈
- 疲倦
- 噁心
優勢
- 副作用較 levetiracetam 輕微
- 行為/精神副作用發生率較低
- 無需劑量調整即可開始使用目標劑量
藥物交互作用
- 與 CYP2C19 相關代謝
- rifampin 可能降低其血中濃度
- 避免與酒精併用
藥物-食物交互作用 (DFI)
資料來源：DDInter 2.0（原文內容請參閱該網站）
酒精 🟡 Moderate
- 影響：產生協同作用。
- 建議：避免大量攝取。
藥物-草藥交互作用 (DHI)
卡瓦 🔴 Major
- 影響：增強中樞神經抑制作用
- 建議：禁止併用
藥物-疾病注意事項 (DDSI)
資料來源：DDInter 2.0（原文內容請參閱該網站）
Depressive Disorder 🟡 Moderate
- 注意事項：Antiepileptic drugs (AEDs) have been associated with an increased risk of suicidal thoughts or behavior in patients taking these drugs for any indicat…
Bronchial Spasm 🟡 Moderate
- 應謹慎使用本藥物。
肝臟疾病 🟡 Moderate
- 需定期監測。可能需要調整劑量。
腎臟疾病 🟡 Moderate
- 不建議使用本藥物。通常無需調整劑量。
結論與下一步
證據等級：L3 (光敏感性癲癇的臨床研究間接支持)
建議：
- 對於光敏感性或視覺誘發性癲癇患者，brivaracetam 是合理的治療選擇
- 可考慮從 levetiracetam 轉換，尤其當患者有行為副作用時
- 建議劑量：成人每日 50-200 mg，分兩次服用
下一步研究方向：
- 針對視覺性癲癇亞型的前瞻性臨床試驗
- 評估 brivaracetam 與其他第三代抗癲癇藥物在此適應症的比較效益
- 收集真實世界數據以支持適應症擴展
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引用本報告
如需引用本報告，請使用以下格式：
APA 格式：
TwTxGNN. (2026). Brivaracetam老藥新用驗證報告. https://twtxgnn.yao.care/drugs/brivaracetam/
BibTeX 格式：
@misc{twtxgnn_brivaracetam,
title = {Brivaracetam老藥新用驗證報告},
author = {TwTxGNN Team},
year = {2026},
url = {https://twtxgnn.yao.care/drugs/brivaracetam/}
}
免責聲明
本報告僅供學術研究參考，不構成醫療建議。藥物使用請遵循醫師指示，切勿自行調整用藥。任何老藥新用決策需經過完整的臨床驗證與法規審查。
最後審核：2026-02-20 | 審核者：TwTxGNN Research Team
本報告僅供學術研究參考，不構成醫療建議。藥物使用請遵循醫師指示，切勿自行調整用藥。任何老藥新用決策需經過完整的臨床驗證與法規審查。
最後審核：2026-02-20 | 審核者：TwTxGNN Research Team
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