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

S. Juhl, G. Rubboli

Research output: Contribution to journalComment/debate

23 Citations (Scopus)

Abstract

Background: Perampanel (PER) is an antagonist of AMPA receptors that has been approved for adjunctive treatment of partial-onset seizures. Aims: To evaluate effectiveness and safety of PER as add-on treatment in patients with severely refractory focal epilepsy. Methods: 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. Results: 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. Conclusions: 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.

Original languageEnglish
Pages (from-to)374-377
Number of pages4
JournalActa Neurologica Scandinavica
Volume134
Issue number5
DOIs
Publication statusPublished - Nov 1 2016

Fingerprint

Partial Epilepsy
Therapeutics
Seizures
perampanel
AMPA Receptors
Dizziness
Psychiatry
Safety

Keywords

  • drug-refractory focal epilepsy
  • efficacy
  • perampanel
  • psychiatric adverse events
  • safety
  • tolerability

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Perampanel as add-on treatment in refractory focal epilepsy. The Dianalund experience. / Juhl, S.; Rubboli, G.

In: Acta Neurologica Scandinavica, Vol. 134, No. 5, 01.11.2016, p. 374-377.

Research output: Contribution to journalComment/debate

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abstract = "Background: Perampanel (PER) is an antagonist of AMPA receptors that has been approved for adjunctive treatment of partial-onset seizures. Aims: To evaluate effectiveness and safety of PER as add-on treatment in patients with severely refractory focal epilepsy. Methods: 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. Results: 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. Conclusions: 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.",
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N2 - Background: Perampanel (PER) is an antagonist of AMPA receptors that has been approved for adjunctive treatment of partial-onset seizures. Aims: To evaluate effectiveness and safety of PER as add-on treatment in patients with severely refractory focal epilepsy. Methods: 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. Results: 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. Conclusions: 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.

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