Perampanel as add-on treatment in refractory focal epilepsy. The Dianalund experience
- 13 January 2016
- journal article
- Published by Hindawi Limited in Acta Neurologica Scandinavica
- Vol. 134 (5), 374-377
- https://doi.org/10.1111/ane.12558
Abstract
Perampanel (PER) is an antagonist of AMPA receptors that has been approved for adjunctive treatment of partial-onset seizures. To evaluate effectiveness and safety of PER as add-on treatment in patients with severely refractory focal epilepsy. PER was introduced as add-on treatment in 22 consecutive patients with drug-resistant focal epilepsy. PER was started with 2 mg/day at bedtime and was up-titrated by 2 mg/day every 2-4 weeks. All patients suffered from severely refractory focal epilepsy (86% took 2 or more AEDs prior PER initiation; 40% had been submitted to surgery or were surgery candidates; 7 had VNS). After 12 months since PER initiation, the retention rate was 54.5% and the responder rate was 27.2%, including 9.1% seizure-free patients. Mean PER dose in the responders was 8 mg/day (range 4-10). Most common side effects were tiredness, behavioral changes (primarily aggressivity), dizziness and were reported in 59.1% of patients, leading to PER discontinuation in 31.8% of subjects. PER as add-on treatment can achieve clinically meaningful improvement in patients suffering from severely refractory focal epilepses. Further studies are warranted to explore the tolerability profile, with particular focus on psychiatric adverse events.Keywords
This publication has 13 references indexed in Scilit:
- Clinical experience with perampanel: Focus on psychiatric adverse effectsEpilepsy & Behavior, 2014
- A multicenter survey of clinical experiences with perampanel in real life in Germany and AustriaEpilepsy Research, 2014
- First clinical experiences with perampanel—The Kork experience in 74 patientsEpilepsia, 2014
- Preclinical pharmacology of perampanel, a selective non-competitive AMPA receptor antagonistActa Neurologica Scandinavica, 2013
- Perampanel, a selective, noncompetitive α‐amino‐3‐hydroxy‐5‐methyl‐4‐isoxazolepropionic acid receptor antagonist, as adjunctive therapy for refractory partial‐onset seizures: Interim results from phase III, extension study 307Epilepsia, 2012
- Evaluation of adjunctive perampanel in patients with refractory partial‐onset seizures: Results of randomized global phase III study 305Epilepsia, 2012
- Adjunctive perampanel for refractory partial-onset seizuresNeurology, 2012
- Randomized phase III study 306Neurology, 2012
- Perampanel: A novel, orally active, noncompetitive AMPA-receptor antagonist that reduces seizure activity in rodent models of epilepsyEpilepsia, 2011
- Revisiting AMPA Receptors as an Antiepileptic Drug TargetEpilepsy Currents, 2011