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Ther Adv Neurol Disord. 2016 Nov;9(6):445-453. Epub 2016 Sep 1.

Two-year real-world experience with perampanel in patients with refractory focal epilepsy: Austrian data.

Author information

1
Department of Neurology, Christian Doppler Medical Klinik of the Paracelsus Medical University Salzburg, Ignaz-Harrer-Straße 79, A-5020 Salzburg, Austria.
2
Department of Neurology, Christian Doppler Medical Klinik of the Paracelsus Medical University Salzburg, Salzburg, Austria.

Abstract

BACKGROUND:

The aim of this study was to analyse registry data of seizure outcome and adverse events (AEs) for perampanel as add-on therapy in patients with focal epilepsy since its approval in 2012 for adjunctive treatment of focal epilepsy in patients ⩾12 years.

METHOD:

A retrospective 2-year chart review of all patients receiving perampanel was carried out.

RESULTS:

A total of 122 patients received perampanel [median treatment length: 20.1 (range: 3.4-26.8) months]; 71 (58%) remained on treatment at last follow up. Overall, 33 patients (27%) were seizure-free for ⩾3 months at last follow up; of these, eight were seizure free for ⩾3 times the longest interictal interval before perampanel therapy; 18 (15%) had reduced seizure frequency ⩾50%. A total of 58 (47%) had an AE and 34 (28%) withdrew from treatment because of AEs. AEs included dizziness (33%), fatigue (12%), psychiatric symptoms (8%), cognitive deficits (7%), speech problems (5%), nausea (4%) and gait problems (4%). AEs subsided in 17/18 patients (94%) following a 2 mg dose reduction. A total of 43 (35%) took a concomitant enzyme inducer. Patients not taking enzyme inducers were more likely to be seizure free (p = 0.002); there were no other between-group differences.

CONCLUSIONS:

Perampanel was well tolerated and improved seizure control in 42% of patients (50- 100% reduction), with higher rates in those not receiving a concomitant enzyme inducer. AEs, particularly dizziness, were common but often disappeared with a slight dose reduction. The results are consistent with those from randomized controlled trials.

KEYWORDS:

clinical experience; efficacy; focal epilepsy; perampanel; tolerability

Conflict of interest statement

The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: A. Rohracher has acted as a paid consultant for Neuroconsult and received travel support from Eisai. J. Dobesberger has received honoraria from UCB Pharma, Gerot Lanach Pharma GmbH, Eisai, and GlaxoSmithKline and received travel support from UCB Pharma, Gerot Lanach Pharma GmbH, Eisai, GlaxoSmithKline and Neurodata Handels GmbH/Micromed Austria. C. A. Granbichler received travel support from Cyberonics and Eisai. J. Höfler has received speaker honoraria from UCB and travel support from UCB and Eisai. M. Leitinger received travel support from Medtronic. G. Kalss received travel support from UCB. I. Deak, G. Kuchukhidze and A. Thomschewski have nothing to disclose. E. Trinka has acted as a paid consultant for Eisai, Ever Neuropharma, Biogen Idec, Medtronics, Bial, Sanofi-Aventis, Takeda, SAGE, Genzyme and UCB. He has received research funding from UCB, Biogen-Idec, Sanofi-Aventis, Genzyme, FWF, Jubiläumsfond der Österreichischen Nationalbank and Red Bull as well as speakers’ honoraria from Bial, Eisai, Ever Neuropharma, GL Lannacher, Genzyme, Biogen, Glaxo Smith Kline, Sanofi-Aventis, Boehringer, Viropharma, Actavis and UCB.

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