Test Catalog

Test Id : BRIVA

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Brivaracetam, Plasma

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Overview

Test Catalog

Useful For
Suggests clinical disorders or settings where the test may be helpful

Assessing compliance and toxicity for brivaracetam

Method Name
A short description of the method used to perform the test

Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Brivaracetam, P

Aliases
Lists additional common names for a test, as an aid in searching

Briviact

Specimen Type
Describes the specimen type validated for testing

Plasma EDTA

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Supplies: Sarstedt Aliquot Tube 5 mL (T914)

Collection Container/Tube:

Preferred: Lavender top (K2 EDTA)

Acceptable: Lavender top (K3 EDTA), green top (sodium or lithium heparin), light-blue top (sodium citrate)

Submission Container/Tube: Plastic vial

Specimen Volume: 1 mL

Collection Instructions:

1. Draw blood immediately before next scheduled dose.

2. For sustained-release formulations only, draw blood a minimum of 12 hours after last dose.

3. Within 2 hours of collection, centrifuge and aliquot plasma into a plastic vial.

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.

0.5 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Gross hemolysis OK
Gross lipemia OK
Gross icterus OK

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Plasma EDTA Refrigerated (preferred) 28 days
Ambient 28 days
Frozen 28 days

Useful For
Suggests clinical disorders or settings where the test may be helpful

Assessing compliance and toxicity for brivaracetam

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Brivaracetam is a newer antiepileptic drug, an analogue of levetiracetam, that is used as therapy for partial onset seizures in patients one month or older. It is available in both an oral and intravenous solution and oral tablet. When taken orally, it is rapidly and completely absorbed. It is primarily excreted through the renal system and has an elimination half-life of approximately nine hours. While the exact mechanism for brivaracetam's anticonvulsive effects is unknown, it has a high and selective binding affinity for synaptic vesicle protein 2A in the brain. The drug has a narrow therapeutic range and a wide interindividual variability in rate of elimination.

 

Adults and children 16 years and older typically take 25 mg twice daily up to 100 mg twice daily. Trough therapeutic reference ranges in plasma have been reported between 0.5 to 0.9 mcg/mL (mg/L) with toxicity more common above 1.8 mcg/mL. The most common adverse effects include somnolence/sedation, dizziness, fatigue, and nausea/vomiting. Vertigo, balance disorder, fatigue, nausea, diplopia, anxiety, and bradycardia have also been reported following brivaracetam overdose.

Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

0.2-2.0 mcg/mL

Interpretation
Provides information to assist in interpretation of the test results

The report is intended for use by a physician to determine if the patient is receiving a dose sufficient to achieve a therapeutic effect or to assess whether the patient is compliant with prescribed dose. The reference range represents the concentrations observed to be associated with greatest drug efficacy without side effects or toxicity.

 

Most individuals display optimal response to brivaracetam with plasma levels 0.2 to 2.0 mcg/mL. Some individuals may respond well outside of this range or may display toxicity within the therapeutic range; thus, interpretation should include clinical evaluation. Toxic levels have not been well established. Therapeutic ranges are based on specimens collected at trough (ie, immediately before the next dose).

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

This test cannot be performed on whole blood.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Patsalos PN, Spencer EP, Berry DJ. Therapeutic drug monitoring of antiepileptic drugs in epilepsy: A 2018 Update. Ther Drug Monit. 2018;40(5):526-548

2. Aalapati KK., Amit S, Patnaik, RS. Method development and validation of a novel UHPLC coupled with MS/MS system for the estimation of brivaracetam in human (K2EDTA) plasma samples and its application to pharmacokinetic study. Curr Pharm Anal. 2022;18.5:504-512

3. Hiemke C, Bergemann N, Clement HW, et al. Consensus guidelines for therapeutic drug monitoring in neuropsychopharmacology: Update 2017 [published correction appears in Pharmacopsychiatry. 2018 Jan;51(1-02):e1]. Pharmacopsychiatry. 2018;51(1-02):9-62

4. Khaleghi F, Nemec EC 2nd. Brivaracetam (Briviact): A novel adjunctive therapy for partial-onset seizures. P T. 2017;42(2):92-96

5. Mohamed S, Riva R, Contin M. Development and validation of an UHPLC-MS/MS assay for the therapeutic monitoring of brivaracetam plasma concentrations in patients with epilepsy. Ther Drug Monit. 2020;42(3):445-451

Method Description
Describes how the test is performed and provides a method-specific reference

The plasma sample is diluted in an acetonitrile internal standard. The protein precipitate is centrifuged, and a portion of the supernatant is diluted with mobile phase 1 for analysis using liquid chromatography tandem mass spectrometry.(Unpublished Mayo method)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Friday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

Same day/1 to 2 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

14 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their account representative. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

80299

LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
BRIVA Brivaracetam, P 88894-1
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
620767 Brivaracetam, P 88894-1

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports

Test Update Resources

Change Type Effective Date
New Test 2024-07-09