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

• Published in: Therapeutic advances in neurological disorders 2016-11, Vol.9 (6), p.445-453
• Main Authors: Rohracher, Alexandra, Kalss, Gudrun, Leitinger, Markus, Granbichler, Claudia, Deak, Ildiko, Dobesberger, Judith, Kuchukhidze, Giorgi, Thomschewski, Aljoscha, Höfler, Julia, Trinka, Eugen
• Format: Article
• Language: English
• Subjects: Clinical trials; Cognitive ability; Convulsions & seizures; Enzymes; Epilepsy; Gait; Nausea; Original Research; Seizures
• ISSN: 1756-2864; 1756-2856; 1756-2864
• DOI: 10.1177/1756285616661115

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.