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Analysis of the clinical experience with perampanel in the Moscow Region: Efficacy, tolerability, individual choice priorities

https://doi.org/10.14412/2074-2711-2017-1S-48-53

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Abstract

Objective: to analyze our clinical experience with perampanel (PER), by evaluating the efficacy, tolerability, and individual choice priorities.

Patients and methods. The investigation enrolled 28 patients with drug-resistant focal epilepsy; the patients' mean age was 38.3±10.7 years. The proportion of men was 46.4%; the disease duration was 8 to 33 years (mean 20.2 years). Antiepileptic drugs (AEDs) were changed 7–10 times in 66% of the patients and 5–6 times in 23%. The efficacy and tolerability of AEDs and the electroclinical features of epilepsy were compared in two groups: responders and non-responders.

Results and discussion. The responder and non-responder groups had a substantial preponderance of patients with frontal lobe epilepsy and diffuse epileptiform electroencephalographic (EEG) patterns (80%:46% and 80%:38%, respectively; p = 0.0001), but those with temporal lobe epilepsy and isolated regional EEG patterns were 2–3 times fewer (20%: 53.8% and 20%:61.5%; p = 0.0001). Only one of 10 combinations of carbamazepine (CBM) and PER was successful. Aggression, fear, and psychosis, which occurred in 5 (17.8%) patients taking PER 2–6 mg/day, were the most common adverse reactions associated with its discontinuation. PER is an effective agent to overcome of drug resistance in epilepsy. The benefit of the drug is that it may be used in undifferentiated antiepileptic therapy regimens. When predicting the effects of PER, preliminary switch from CBZ to oxcarbazepine or eslicarbazepine is reasonable. 

About the Authors

I. G. Rudakova
M.F. Vladimirsky Moscow Regional Research Clinical Institute
Russian Federation
61/2, Shchepkin St., Moscow 129110


Yu. A. Belova
M.F. Vladimirsky Moscow Regional Research Clinical Institute
Russian Federation
61/2, Shchepkin St., Moscow 129110


References

1. Карлов ВА. Фармакорезистентность и толерантность. В кн.: Эпилепсия у детей и взрослых женщин и мужчин: Руководство для врачей. Москва: Медицина; 2010. C. 667-76. [Karlov VA. Pharmacoresistance and tolerance. In: Epilepsiya u detei i vzroslykh muzhchin i zhenshchin (Epilepsy in children and adult men and women]. Moscow: Medicina; 2010. P. 667-76)].

2. Brodie MJ. Medical therapy of epilepsy: When to initiate treatment and when to combine? J Neurol. 2005;252:125-30. doi: 10.1007/s00415-005-0735-x

3. Kvan P, Schachter SC, Brodie MJ. Drug-resistant epilepsy. N Engl J Med. 2011 Sep 8;365(10):919-26. doi: 10.1056/NEJMra1004418

4. Rogawski MA. Revisiting AMPA receptors as an antiepileptic drug target. Epilepsy Curr. 2011;11:56-63. doi: 10.5698/1535-7511-11.2.56

5. Patsalos PN. The clinical pharmacology profile of the new antiepileptic drug perampanel: a novel noncompetitive AMPA receptor antagonist. Epilepsia. 2015;56:12-27. doi: 10.1111/epi.12865

6. Hanada T, Hashizume Y, Tokuhara N, et al. Perampanel: a novel, orally active, noncompetitive AMPA-receptor antagonist that reduces seizureactivity in rodent models of epilepsy. Epilepsia. 2011;52:1331-40. doi: 10.1111/j.1528-1167.2011.03109

7. Schiller Y, Najjar Y. Quantify in the response to antiepileptic drugs: effect of past treatment history. Neurology. 2008;70(1):54-65. doi: 10.1212/01.wnl.0000286959.22040.6e

8. French JA, Krauss GL, Steinhoff BJ, et al. Evaluation of adjunctive perampanel in patients with refractory partial-onset seizures: Results of randomized global phase III study 305. Epilepsia. 2013;54(1):117-25. doi: 10.1111/j.1528-1167.2012.03638.x

9. Krauss GL, Serratosa JM, Villanueva V, et al. Randomized phase III study 306: adjunctive perampanel for refractory partial-onset seizures. Neurology. 2012;78:1408-15. doi: 10.1212/WNL.0b013e318254473a

10. Krauss GL, Perucca E, Ben-Menachem E, et al. Long-term safety of perampanel and seizure outcomes in refractory partial-onset seizures and secondarily generalized seizures: Results from phase III extension study 307. Epilepsia. 2014;55:1058-68. doi: 10.1111/epi.12643

11. Steinhoff BJ, Ben-Menachem E, Ryvlin P, et al. Efficacy and safety of adjunctive perampanel for the treatment of refractory partial seizures: A pooled analysis of three phase III studies. Epilepsia. 2013;54(8):1481-9. doi: 10.1111/epi.12212

12. French JA, Krauss GL, Wechsler RT, et al. Perampanel for tonic-clonic seizures in idiopathic generalized epilepsy. A randomized trial. Neurology. 2015;85:1-8. doi: 10.1212/WNL.0000000000001930

13. Карлов ВА, Беляев ОВ, Власов ПН и др. Российский опыт применения перампанела в повседневной клинической практике. Неврология, нейропсихиатрия, психосоматика. 2016;(1S):11-7 [Karlov VA, Belyaev OV, Vlasov PN, et al. Russian experience with perampanel in routine clinical practice. Nevrologiya, Neiropsikhiatriya, Psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2016;(1S):11-7 (In Russ.)]. doi: 10.14412/2074-2711-2016-1S-11-17

14. Steinhoff BJ, Bacher M, Bast T, et al. First clinical experiences with perampanel – the Kork experience in 74 patients. Epilepsia. 2014;55 Suppl 1:16-8. doi: 10.1111/epi.12492

15. Pilay N, Hwang P, Mclachlan R. Canadian experience with extended use of over 3 years of perampanel in partial-onset seizures in patients aged 12 and above. 30th International Epilepsy Congress; 23–27 June; Montreal, Canada, 2013.

16. Trinka E, Steinhoff BJ, Nikanorova M, Brodie MJ. Perampanel for focal epilepsy: insights from early clinical experience. Acta Neurol Scand. 2016;133:160-72. doi: 10.1111/ane.12529

17. Patsalos PN. Drug Interactions With the Newer Antiepileptic Drugs (AEDs) – Part 1: Pharmacokinetic and Pharmacodynamic Interactions Between AEDs. Clin Pharmacokinet. 2013;(52):927-66. doi: 10.1007/s40262-013-0087-0

18. Инструкция по применению лекарственного препарата для медицинского применения от 29.06.2015. Файкомпа®. Регистрационный номер: ЛП-002200. Международное непатентованное название: Перампанел [Instructions for use of the drug for medical use from /29/2015. Faykompa®. Registration number: PL-002200.International nonproprietary name: Perampanel].

19. Инструкция по применению лекарственного препарата для медицинского применения Трилептал®. Регистрационный номер: П N015199/01-011014. Международное непатентованное название: Окскарбазепин [Instructions for use of the drug for medical use Trileptal®. Registration number: П N015199/01-011014. International nonproprietary name: Oxcarbazepin].

20. Инструкция по применению лекарственного препарата для медицинского применения Эксалиеф®. Регистрационный номер: ЛП-001263. Международное непатентованное название: Эсликарбазепин [Instructions for use of the drug for medical use Exalief®. Registration number: PL-001263. International nonproprietary name: Eslicarbazepin].

21. Рудакова ИГ. Лекарственные взаимодействия Эсликарбазепина. Эпилепсия и пароксизмальные состояния. 2015;Спецвыпуск: Эксалиэф: новые перспективы лечения эпилепсии:5-7 [Rudakova IG. Drug Interactions of Eslikarbazepine. Epilepsiya i Paroxizmalniye Sostoyaniya. 2015;Spezvipusk. Exalief: noviye perspektivi lecheniya epilepsii: 5-7 (In Russ.)].

22. Peltola J, Holtkamp M, Rocamora R, et al. Practical guidance and consideration for transitioning patients from oxcarbazepine or carbamazepine to eslicarbazepine acetate – Expert opinion. Epilepsy Behav. 2016;50:46-9. doi: 10.1016/j.yebeh.2015.05.036

23. La Neve A, Boero G, Francavilla T, Striano P. Swinching to eslicarbazepine acetate in patients with epilepsy: a field-practice observation. 2017 Future Medicine Ltd. doi: 10.2217/fnl-2016-0021

24. Рудакова ИГ. Рациональный подход к комбинированной терапии фокальной эпилепсии. Эпилепсия. 2014;(4):62-6 [Rudakova IG. Rational approach to combined therapy of focal epilepsy. Epilepsia = Epilepsy. 2014;(4):62-6 (In Russ.)].


For citation:


Rudakova I.G., Belova Y.A. Analysis of the clinical experience with perampanel in the Moscow Region: Efficacy, tolerability, individual choice priorities. Neurology, Neuropsychiatry, Psychosomatics. 2017;9(1S):48-53. (In Russ.) https://doi.org/10.14412/2074-2711-2017-1S-48-53

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ISSN 2074-2711 (Print)
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