Perampanel as add-on therapy in epilepsies with known etiology: A single center experience with long-term follow-up

Annacarmen Nilo; Giada Pauletto; Gian Luigi Gigli; Alberto Vogrig; Pierluigi Dolso; Mariarosaria Valente

doi:10.1016/j.ebr.2020.100393

Perampanel as add-on therapy in epilepsies with known etiology: A single center experience with long-term follow-up

Epilepsy Behav Rep. 2020 Oct 26:15:100393. doi: 10.1016/j.ebr.2020.100393. eCollection 2021.

Authors

Annacarmen Nilo^{1

2}, Giada Pauletto³, Gian Luigi Gigli^{1

2

4}, Alberto Vogrig², Pierluigi Dolso², Mariarosaria Valente^{1

2}

Affiliations

¹ Department of Medicine (DAME), University of Udine Medical School, Udine, Italy.
² Clinical Neurology Unit, Department of Neurosciences, S. Maria della Misericordia University Hospital, Udine, Italy.
³ Neurology Unit, Department of Neurosciences, S. Maria della Misericordia University Hospital, Udine, Italy.
⁴ DMIF, University of Udine, Udine, Italy.

Abstract

We report a retrospective monocentric study performed on 63 patients affected by epilepsy with known etiology, receiving perampanel as add-on therapy with at least 12-month follow-up. The purpose of our study was to evaluate efficacy and tolerability of perampanel in this group of epilepsies. Patients were classified into 2 groups based on the presence/absence of a single focal brain lesion on MRI, as epilepsy etiology: 48 subjects were affected by focal lesional epilepsy and 15 by non-focal lesional epilepsy. The retention rate was 76.2% and 53.9% at 12 and 24 months respectively. At 12 months, at least 40% of patients resulted responders, with a significant reduction in seizure frequency (p = 0.01), confirmed at 24 months. Considering epilepsy etiology, we found a better PER response in patients with focal lesional epilepsy. A significant correlation was observed between responder rates and EEG pattern. Only 30% of patients reported mild-moderate adverse events. Efficacy and tolerability of PER, in our study, are in line with the results reported in other real-world studies. Our data suggest the possibility of better PER response in patients with focal brain lesions, which indicates that this drug could be a therapeutic option in this population.

Keywords: AE, adverse event; AMPA receptors; ASM, anti-seizure medication; Brain lesion; CTCAE, Common Terminology Criteria for Adverse Events; EEG, electroencephalogram; Efficacy; EiASM, enzyme-inducing anti-seizure medication; ILAE, International League Against Epilepsy; MRI, Magnetic Resonance Imaging; PER, perampanel; Perampanel; Real-world data; Seizures; TLE, temporal lobe epilepsy.