Efficacy and tolerability of perampanel as a first add-on therapy with different anti-seizure drugs.

Autor: Santamarina E; Hospital Universitario Vall d'Hebron, Barcelona, Spain. Electronic address: esantama@vhebron.net., Bertol V; Hospital Universitario Miguel Servet, Zaragoza, Spain., Garayoa V; Hospital Universitario Miguel Servet, Zaragoza, Spain., García-Gomara MJ; Hospital Royo Villanova, Zaragoza, Spain., Garamendi-Ruiz I; Hospital Universitario de Cruces, Barakaldo, Spain., Giner P; Hospital Universitario Doctor Peset, Valencia, Spain., Aranzábal I; Hospital Universitario Basurto, Bilbao, Spain., Piera A; Hospital Clínico Universitario, Valencia, Spain., Arcos C; Hospital General de la Defensa, Zaragoza, Spain., Esteve P; Hospital Verge de la Cinta, Tortosa, Spain., Marinas A; Hospital Universitario de Cruces, Barakaldo, Spain., García-Escrivá A; Hospital Marina Salud Dènia, Alicante, Spain., Viloria-Alebesque A; Hospital General de la Defensa, Zaragoza, Spain., Loro FA; Complejo Hospitalario Universitario, Toledo, Spain., de Tienda AP; Hospital Clínico Universitario, Valencia, Spain., Olivan JA; Hospital de Barbastro, Huesca, Spain., Bonet M; Hospital Arnau de Vilanova, Valencia, Spain., Dávila-González P; Hospital de Manacor, Mallorca, Spain., Sivera R; Hospital Francesc de Borja, Gandía, Spain., Molins A; Hospital Universitario Doctor Josep Trueta, Girona, Spain., Sansa G; Corporació Sanitària Parc Taulí, Sabadell, Spain., Roche JC; Hospital General de la Defensa, Zaragoza, Spain., Martínez AB; Hospital Universitario Son Espases, Mallorca, Spain., Monteagudo S; Hospital Comarcal de Inca, Mallorca, Spain., Casadevall T; Hospital Sant Jaume de Calella, Girona, Spain.
Jazyk: angličtina
Zdroj: Seizure [Seizure] 2020 Dec; Vol. 83, pp. 48-56. Date of Electronic Publication: 2020 Oct 07.
DOI: 10.1016/j.seizure.2020.09.026
Abstrakt: Purpose: To investigate the efficacy and tolerability of perampanel (PER) when administered as a first add-on therapy to patients with focal epilepsy or idiopathic generalized epilepsy (IGE) taking one other antiseizure drug (ASD).
Methods: This multicentre, retrospective, one-year observational study collected data from patients (≥12 years) who initiated treatment with PER as first add-on therapy. Patients had to be experiencing inadequate seizure control on ASD monotherapy and tried ≤3 ASD monotherapies before initiating PER. Multivariate logistic regression analyses were performed, adjusted for the number and type of previous seizures, duration and aetiology of epilepsy.
Results: Of the 149 patients included in the study (mean age 41 years; 54.4 % male), 118 (79.2 %) were still receiving PER as first add-on treatment after 12 months. Mean PER dose was 6.2 mg/day. At 12 months, 45.6 % were seizure-free and 84.6 % responders. A significant difference in seizure freedom rate was found between patients with IGE and patients with focal epilepsy, but not in responders. Reduced seizure control was observed when PER was administered with strong enzyme-inducing ASDs; conversely, increased seizure control was seen when the same dose of PER was combined with enzyme-inhibiting ASDs. The most frequent adverse events were dizziness (15.4 %), irritability (14.1 %) and drowsiness (14.1 %); no differences in tolerance were observed among different combinations.
Conclusion: PER demonstrated a good efficacy and safety profile when used as a first add-on therapy in patients who did not respond to monotherapy. PER dose adjustments may optimize seizure control when combined with strong enzyme-inducing or enzyme-inhibiting ASDs.
(Copyright © 2020 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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