Perampanel as add-on treatment in refractory focal epilepsy. The Dianalund experience

Acta Neurologica Scandinavica
S Juhl, G Rubboli

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 adv...Continue Reading

Associated Clinical Trials

References

Jun 21, 2011·Epilepsy Currents·Michael A Rogawski
Jul 31, 2012·Neurology·Jacqueline A FrenchMichael A Rogawski
Mar 27, 2013·Acta Neurologica Scandinavica. Supplementum·M A Rogawski, T Hanada
Dec 24, 2013·Epilepsy & Behavior : E&B·Bernd Huber
Jan 10, 2014·Epilepsia·Bernhard J SteinhoffIlona Wisniewski
Apr 12, 2014·Epilepsy Research·Bernhard J SteinhoffSoheyl Noachtar
Dec 3, 2014·Epilepsy & Behavior : E&B·Helen CoyleRajiv Mohanraj

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Citations

Jun 2, 2017·Acta Neurologica Scandinavica·E AndresM Winterholler
Jun 19, 2017·Epilepsy & Behavior : E&B·Tim WehnerJosemir W Sander
Dec 19, 2017·Acta Neurologica Scandinavica·T NishidaS Kaneko
Oct 13, 2017·Expert Opinion on Pharmacotherapy·Carlo Di BonaventuraEmilio Russo
Dec 8, 2017·Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova·F K Rider
Sep 1, 2018·Expert Opinion on Drug Safety·Romina MoaveroPaolo Curatolo
Jan 13, 2018·Reviews in the Neurosciences·Nitika GargBikash Medhi
May 10, 2020·Acta Neurologica Scandinavica·Jon AllardRohit Shankar
Sep 21, 2020·Reviews in the Neurosciences·Sumaira KhanDivya Vohora
Jun 5, 2017·Italian Journal of Pediatrics·Paola De LisoAlberto Verrotti
Feb 28, 2019·Journal of Epilepsy Research·Soo Yeon KimKi Joong Kim

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