Format

Send to

Choose Destination
Seizure. 2016 Jan;34:1-5. doi: 10.1016/j.seizure.2015.10.017. Epub 2015 Nov 10.

Clinical experience with adjunctive perampanel in adult patients with uncontrolled epilepsy: A UK and Ireland multicentre study.

Author information

1
Department of Clinical and Health Psychology, St James's University Hospital, Leeds, LS9 7TF, United Kingdom. Electronic address: emily.shah@kcl.ac.uk.
2
Department of Neurology, Royal Hallamshire Hospital, Sheffield, S10 2JF, United Kingdom.
3
Department of Neurology, Leeds General Infirmary, Leeds, LS1 3EX, United Kingdom.
4
Department of Neurology, Beaumont Hospital, Dublin, Dublin 9, United Kingdom.
5
Department of Clinical and Health Psychology, St James's University Hospital, Leeds, LS9 7TF, United Kingdom.

Abstract

PURPOSE:

To derive clinically useful information about the efficacy and tolerability of adjunctive treatment with perampanel for refractory epilepsy in an outpatient setting.

METHOD:

We pooled retrospective casenotes data of adult patients with refractory epilepsy prescribed perampanel from 18 hospitals throughout UK and Ireland.

RESULTS:

Three hundred and ten patients were included (mean age 40.9 [SD=12.0], 50% women, 27.7% with learning disability). The mean duration of epilepsy was 26.7 years (range 2-67 years, SD=13.5) and 91.9% were taking two or more anti-epileptic drugs at the time of perampanel initiation. Mean retention was 6.9 months (range 1 day-22.3 months, SD=4.5). The retention was 86% at 3 months, 71% at 6 months, 47.6% at 12 months and 27% at 18 months. At final follow-up a >50% reduction in seizure frequency was reached in 57.5% of tonic-clonic seizures, 57.4% of complex partial seizures and 43.8% of simple partial seizures. Eleven patients (3.5%) became seizure free. Two hundred and nine patients (67.4%) experienced adverse effects and of these 67% withdrew treatment due to their effects. The most common were sedation, behaviour/mood disturbance, dizziness, and unsteadiness.

CONCLUSION:

Perampanel appears a safe and effective antiepileptic drug when used as adjunctive therapy in patients with uncontrolled partial epilepsy (including those with learning disability), although few patients achieved complete seizure control. Long-term retention was slightly lower than reported rates for other anti-epileptic drugs, potentially due to the highly refractory population. Monitoring for adverse effects on energy levels, mood and behaviour is recommended.

KEYWORDS:

Antiepileptic drug; Efficacy; Epilepsy; Perampanel; Responder rate; Tolerability

PMID:
26615577
DOI:
10.1016/j.seizure.2015.10.017
[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center