TY - JOUR
T1 - Perampanel effectiveness and tolerability in patients with epilepsy at long-term follow-up
AU - Fernandes, Mariana
AU - Dainese, Filippo
AU - Operto, Francesca
AU - Lattanzi, Simona
AU - Matricardi, Sara
AU - Renna, Rosaria
AU - Placidi, Fabio
AU - Paladin, Francesco
AU - Pastorino, Grazia Maria Giovanna
AU - Foschi, Nicoletta
AU - Cesaroni, Elisabetta
AU - Mercuri, Nicola Biagio
AU - Liguori, Claudio
N1 - Funding Information:
Simona Lattanzi has received speaker's or consultancy fees from Eisai, UCB Pharma, and GW Pharmaceuticals and has served on the advisory board for GW Pharmaceuticals. Claudio Liguori has received speaker's or consultancy fees and served on the advisory board for Eisai. The other authors have no conflict of interests or financial disclosures.
Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2021/8
Y1 - 2021/8
N2 - Introduction: The main of the present study was to assess the effectiveness and tolerability of perampanel (PER) in association with 1 or 2 concomitant antiseizure medications (ASMs) in patients with epilepsy throughout a follow-up period of 24 months or longer in a real-world setting. Methods: This retrospective, observational, multi-center study collected data from both underage (<18 years old) and adult patients who had started PER in association with 1 or 2 ASMs. Only patients who had started PER and were followed up for at least 24 months were included. Response to treatment was analyzed at the 24-, 36-, and 48-month visits by considering the last visit undergone by patients. Subgroup analyses were performed according to age, gender, and epilepsy type and patients were categorized following PER treatment in concomitance with 1 or 2 ASMs to evaluate the factors affecting the achievement of seizure freedom (SF) at the 24-month FU. Results: Ninety-four patients were included (mean age 36.89 years; 51.1% female). At the 24-month follow-up visit, 90 (95.74%) patients were still receiving PER concomitantly with 1 or 2 ASMs. The mean PER dose was 6.02 mg/day and SF was achieved by 33 (35.1%) patients. A significantly higher SF rate was found in patients who had started PER with only 1 ASM when compared to those who had started PER with 2 concomitant ASMs. Effectiveness was maintained also in the subgroups of patients with a 36- or 48-month follow-up visit. Adult patients had a higher final daily dosage of PER than underage patients. Logistic regression found that the lowest number of previously failed ASMs was associated with a higher SF rate (p = 0.036). Conclusion: Perampanel demonstrated a good effectiveness in association with 1 or 2 ASMs in both pediatric and adult patients, without having to use a high dose of the drug. The possibility to present SF was higher when PER was added early. Finally, the maintenance of effectiveness was observed also in the subgroups of patients with a follow-up of 36 and 48 months.
AB - Introduction: The main of the present study was to assess the effectiveness and tolerability of perampanel (PER) in association with 1 or 2 concomitant antiseizure medications (ASMs) in patients with epilepsy throughout a follow-up period of 24 months or longer in a real-world setting. Methods: This retrospective, observational, multi-center study collected data from both underage (<18 years old) and adult patients who had started PER in association with 1 or 2 ASMs. Only patients who had started PER and were followed up for at least 24 months were included. Response to treatment was analyzed at the 24-, 36-, and 48-month visits by considering the last visit undergone by patients. Subgroup analyses were performed according to age, gender, and epilepsy type and patients were categorized following PER treatment in concomitance with 1 or 2 ASMs to evaluate the factors affecting the achievement of seizure freedom (SF) at the 24-month FU. Results: Ninety-four patients were included (mean age 36.89 years; 51.1% female). At the 24-month follow-up visit, 90 (95.74%) patients were still receiving PER concomitantly with 1 or 2 ASMs. The mean PER dose was 6.02 mg/day and SF was achieved by 33 (35.1%) patients. A significantly higher SF rate was found in patients who had started PER with only 1 ASM when compared to those who had started PER with 2 concomitant ASMs. Effectiveness was maintained also in the subgroups of patients with a 36- or 48-month follow-up visit. Adult patients had a higher final daily dosage of PER than underage patients. Logistic regression found that the lowest number of previously failed ASMs was associated with a higher SF rate (p = 0.036). Conclusion: Perampanel demonstrated a good effectiveness in association with 1 or 2 ASMs in both pediatric and adult patients, without having to use a high dose of the drug. The possibility to present SF was higher when PER was added early. Finally, the maintenance of effectiveness was observed also in the subgroups of patients with a follow-up of 36 and 48 months.
KW - Antiseizure medication
KW - Effectiveness
KW - Follow-up
KW - Real-world study
KW - Retention rate
UR - http://www.scopus.com/inward/record.url?scp=85107152755&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85107152755&partnerID=8YFLogxK
U2 - 10.1016/j.yebeh.2021.108069
DO - 10.1016/j.yebeh.2021.108069
M3 - Article
AN - SCOPUS:85107152755
SN - 1525-5050
VL - 121
JO - Epilepsy and Behavior
JF - Epilepsy and Behavior
M1 - 108069
ER -