KMID : 1151120190270030076
|
|
Annals of Child Neurology 2019 Volume.27 No. 3 p.76 ~ p.83
|
|
Efficacy and Tolerability of Low-Dose Perampanel in Patients with Childhood-Onset Intractable Epilepsy
|
|
Park Hyeon-Min
Ahn Hyun-Ji Jang Han-Na Kim Hyun-Jin Yum Mi-Sun Ko Tae-Sung
|
|
Abstract
|
|
|
Purpose: The aim of this study was to evaluate the efficacy and tolerability of perampanel as adjunctive therapy in childhood-onset refractory epilepsy.
Methods: We retrospectively reviewed the medical records of 110 patients who were treated with perampanel in Asan Medical Center children¡¯s hospital. Two patients with poor compliance were excluded and 108 patients were enrolled. The clinical characteristics were reviewed, and the total seizure frequency before and after the add-on of perampanel was analyzed.
Results: The mean age of the patients (64 males) was 20.2 years (range, 10.5 to 35.6). The mean maintenance dose was 4.8 mg/day (2 to 10 mg). Eight patients (7.4%) achieved seizure freedom and 35 (32.4%) achieved a seizure reduction of ¡Ã50%. Among them, three patients achieved seizure freedom with only 2 mg/day of perampanel. There was no significant difference in sex, age at seizure onset, duration of epilepsy, use of concomitant enzyme-inducing antiepileptic drugs, number of concomitant antiepileptic drugs, and adverse events between responders and non-responders. The retention rate was up to 68.0% in the first year and 59.5% in the second year of the study. Thirty-four patients (31.5%) reported adverse events: violence, somnolence, dizziness, drooling, weight gain, insomnia, and vomiting. There was no contributing factor for the adverse events, including sex, age, and the number of concomitant antiepileptic drugs and enzyme-inducing antiepileptic drugs when comparing the adverse event present group with the adverse event absent group.
Conclusion: Low-dose perampanel showed reasonable efficacy and tolerability in patients with refractory childhood-onset epilepsy. Further validation with pharmacokinetic studies is needed.
|
|
KEYWORD
|
|
Perampanel, Drug resistant epilepsy, Drug-related side effects and adverse reactions, Treatment outcome
|
|
FullTexts / Linksout information
|
|
|
|
Listed journal information
|
|
|
|