Efficacy and tolerability of perampanel as a first add-on therapy with different anti-seizure drugs
Por:
Santamarina E, Bertol V, Garayoa V, García-Gomara MJ, Garamendi-Ruiz I, Giner P, Aranzábal I, Piera A, Arcos C, Esteve P, Marinas A, García-Escrivá A, Viloria-Alebesque A, Loro FA, de Tienda AP, Olivan JA, Bonet M, Dávila-González P, Sivera R, Molins A, Sansa G, Roche JC, Martínez AB, Monteagudo S and Casadevall T
Publicada:
1 dic 2020
Ahead of Print:
7 oct 2020
Resumen:
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.
Filiaciones:
Santamarina E:
Hospital Universitario Vall d'Hebron, Barcelona, Spain
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
:
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
:
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
:
Hospital Arnau de Vilanova, Valencia, Spain
Dávila-González P:
Hospital de Manacor, Mallorca, Spain
:
Hospital Francesc de Borja, Gandia, Spain
Molins A:
Hospital Universitario Doctor Josep Trueta, Girona, Spain
Sansa G:
Corporació Sanitària Parc Taulì, 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
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