PMID- 29801910
OWN - NLM
STAT- MEDLINE
DCOM- 20190626
LR  - 20211204
IS  - 1878-5883 (Electronic)
IS  - 0022-510X (Linking)
VI  - 390
DP  - 2018 Jul 15
TI  - Perampanel as adjunctive therapy in highly refractory epilepsies: Real-world data 
      from an Italian tertiary care epilepsy centre.
PG  - 67-74
LID - S0022-510X(18)30186-2 [pii]
LID - 10.1016/j.jns.2018.04.017 [doi]
AB  - Perampanel (PER) is a selective non-competitive 
      alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) receptor antagonist, 
      licensed as adjunctive therapy in focal epilepsy and primary generalized 
      tonic-clonic seizures (pGTCSs). We performed a retrospective study on highly 
      refractory adult patients taking PER, with 1-year follow-up. Retention rate 
      represented the primary outcome of our work; seizure frequency reduction (>/=50%), 
      "switch rate" and proportion of adverse events (AEs) were evaluated as secondary 
      endpoints. Eighty-nine subjects (47 females, age range: 19-78 years) were 
      included. Seventy-three had focal epilepsy (FE), 9 generalized epilepsy and 7 
      epileptic encephalopathy. All patients were highly drug-resistant (medication 
      failures: 5-17). Retention rate was 87.6%, 63% and 51.7% at 3, 6 and 12 months. 
      Responders were 27/89 (30.3%), with 8/27 seizure-free. The number of previous 
      treatment failures and the concomitant use of enzyme inducers negatively 
      influenced clinical response, whereas no correlation was documented between PER 
      dose and outcome. Responder proportion was more satisfying in structural FE than 
      in FE of unknown etiology (33% versus 20%), and in secondarily GTCSs than focal 
      seizures (54% vs 28%), whereas pGTCSs showed a lower reponse rate (25%). 
      Mild-to-moderate AEs (mainly dizziness, gait disturbances and psychiatric 
      effects) were reported by 40% of patients; serious psychiatric AEs usually 
      occurred in subjects with psychiatric comorbidities. Our study confirms the 
      tolerability and effectiveness of PER in highly drug-resistant patients with 
      different epilepsy syndromes and aetiologies.
CI  - Copyright (c) 2018 Elsevier B.V. All rights reserved.
FAU - Morano, Alessandra
AU  - Morano A
AD  - Neurology Unit, Department of Neurosciences and Mental Health, "Sapienza" 
      University, Rome, Italy.
FAU - Fattouch, Jinane
AU  - Fattouch J
AD  - Neurology Unit, Department of Neurosciences and Mental Health, "Sapienza" 
      University, Rome, Italy.
FAU - Albini, Mariarita
AU  - Albini M
AD  - Neurology Unit, Department of Neurosciences and Mental Health, "Sapienza" 
      University, Rome, Italy.
FAU - Casciato, Sara
AU  - Casciato S
AD  - Neurology Unit, Department of Neurosciences and Mental Health, "Sapienza" 
      University, Rome, Italy.
FAU - Fanella, Martina
AU  - Fanella M
AD  - Neurology Unit, Department of Neurosciences and Mental Health, "Sapienza" 
      University, Rome, Italy.
FAU - Basili, Luca Manfredi
AU  - Basili LM
AD  - Neurology Unit, Department of Neurosciences and Mental Health, "Sapienza" 
      University, Rome, Italy.
FAU - Vigano, Alessandro
AU  - Vigano A
AD  - Neurology Unit, Department of Neurosciences and Mental Health, "Sapienza" 
      University, Rome, Italy.
FAU - Manfredi, Mario
AU  - Manfredi M
AD  - Neurology Unit, Department of Neurosciences and Mental Health, "Sapienza" 
      University, Rome, Italy.
FAU - Giallonardo, Anna Teresa
AU  - Giallonardo AT
AD  - Neurology Unit, Department of Neurosciences and Mental Health, "Sapienza" 
      University, Rome, Italy.
FAU - Di Bonaventura, Carlo
AU  - Di Bonaventura C
AD  - Neurology Unit, Department of Neurosciences and Mental Health, "Sapienza" 
      University, Rome, Italy. Electronic address: c_dibonaventura@yahoo.it.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20180412
PL  - Netherlands
TA  - J Neurol Sci
JT  - Journal of the neurological sciences
JID - 0375403
RN  - 0 (Anticonvulsants)
RN  - 0 (Nitriles)
RN  - 0 (Pyridones)
RN  - H821664NPK (perampanel)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Anticonvulsants/adverse effects/*therapeutic use
MH  - Drug Resistant Epilepsy/*drug therapy
MH  - Drug Therapy, Combination
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Italy
MH  - Male
MH  - Middle Aged
MH  - Nitriles
MH  - Pyridones/adverse effects/*therapeutic use
MH  - Retrospective Studies
MH  - Tertiary Healthcare
MH  - Treatment Outcome
MH  - Young Adult
OTO - NOTNLM
OT  - AMPA
OT  - Add-on therapy
OT  - Perampanel
OT  - Refractory epilepsy
OT  - Secondarily generalized tonic-clonic seizures
EDAT- 2018/05/29 06:00
MHDA- 2019/06/27 06:00
CRDT- 2018/05/27 06:00
PHST- 2018/01/25 00:00 [received]
PHST- 2018/03/26 00:00 [revised]
PHST- 2018/04/10 00:00 [accepted]
PHST- 2018/05/27 06:00 [entrez]
PHST- 2018/05/29 06:00 [pubmed]
PHST- 2019/06/27 06:00 [medline]
AID - S0022-510X(18)30186-2 [pii]
AID - 10.1016/j.jns.2018.04.017 [doi]
PST - ppublish
SO  - J Neurol Sci. 2018 Jul 15;390:67-74. doi: 10.1016/j.jns.2018.04.017. Epub 2018 
      Apr 12.