PMID- 33754209
OWN - NLM
STAT- MEDLINE
DCOM- 20210928
LR  - 20210928
IS  - 1432-1459 (Electronic)
IS  - 0340-5354 (Linking)
VI  - 268
IP  - 10
DP  - 2021 Oct
TI  - Efficacy and safety of perampanel in refractory and super-refractory status 
      epilepticus: cohort study of 81 patients and literature review.
PG  - 3744-3757
LID - 10.1007/s00415-021-10506-9 [doi]
AB  - BACKGROUND: The effective dose of perampanel in status epilepticus (SE), 
      refractory SE (RSE), and super-refractory SE (SRSE) in humans is unknown, and the 
      potential of perampanel in treating SE has not been evaluated in a large cohort. 
      METHODS: Data of intensive care patients with RSE and SRSE treated with 
      perampanel were retrospectively reviewed and analyzed. RESULTS: Eighty-one 
      patients received perampanel, including 39 females with median age 64 [17-91] 
      years, perampanel responders (n = 27), and non-responders (n = 54). The initial 
      perampanel dose was positively associated with treatment response in patients 
      with RSE or SRSE (OR = 1.27, 95% CI 1.03-1.57, p = 0.025), while the maximum dose 
      was negatively associated with treatment response (OR = 0.74, 95% CI 0.58-0.96, 
      p = 0.022). Hypoxia caused seizures in six patients; five died in hospital and 
      one had severe disability. A statistically non-significant tendency toward better 
      response was found in patients with unique SE type and cause, particularly in 
      nonconvulsive status epilepticus (NCSE) without coma (NCSE without coma vs. 
      generalized tonic-clonic seizure: OR = 4.14, 95% CI 0.98-17.47, p = 0.053). In 
      the high-dose (>/= 16 mg/day) groups, although distributions of modified Rankin 
      Scale (mRS) scores were similar between perampanel responders and non-responders 
      at discharge, a greater proportion of perampanel responders had less change in 
      mRS scores from baseline than did perampanel non-responders (median mRS: 0 vs 4, 
      p = 0.064). No cardiorespiratory adverse events or laboratory abnormalities were 
      noted with perampanel treatment. CONCLUSIONS: Perampanel is effective and has a 
      satisfactory safety profile in the emergency treatment of established RSE and 
      SRSE.
CI  - (c) 2021. Springer-Verlag GmbH Germany, part of Springer Nature.
FAU - Lim, Siew-Na
AU  - Lim SN
AUID- ORCID: 0000-0001-6867-8449
AD  - Section of Epilepsy, Department of Neurology, Chang Gung Memorial Hospital at 
      Linkou Medical Center and Chang Gung University College of Medicine, 5 Fu-Shin 
      Street, Kwei-Shan, Taoyuan, 333, Taiwan. siewna@adm.cgmh.org.tw.
FAU - Wu, Tony
AU  - Wu T
AD  - Section of Epilepsy, Department of Neurology, Chang Gung Memorial Hospital at 
      Linkou Medical Center and Chang Gung University College of Medicine, 5 Fu-Shin 
      Street, Kwei-Shan, Taoyuan, 333, Taiwan.
AD  - Department of Neurology, Xiamen Chang Gung Hospital, Xiamen, Fujian, China.
FAU - Tseng, Wei-En Johnny
AU  - Tseng WJ
AD  - Section of Epilepsy, Department of Neurology, Chang Gung Memorial Hospital at 
      Linkou Medical Center and Chang Gung University College of Medicine, 5 Fu-Shin 
      Street, Kwei-Shan, Taoyuan, 333, Taiwan.
AD  - Biomedical Engineering, Chang Gung University, Taoyuan, Taiwan.
FAU - Chiang, Hsing-I
AU  - Chiang HI
AD  - Section of Epilepsy, Department of Neurology, Chang Gung Memorial Hospital at 
      Linkou Medical Center and Chang Gung University College of Medicine, 5 Fu-Shin 
      Street, Kwei-Shan, Taoyuan, 333, Taiwan.
FAU - Cheng, Mei-Yun
AU  - Cheng MY
AD  - Section of Epilepsy, Department of Neurology, Chang Gung Memorial Hospital at 
      Linkou Medical Center and Chang Gung University College of Medicine, 5 Fu-Shin 
      Street, Kwei-Shan, Taoyuan, 333, Taiwan.
FAU - Lin, Wey-Ran
AU  - Lin WR
AD  - Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital at 
      Linkou Medical Center and Chang Gung University College of Medicine, Taoyuan, 
      Taiwan.
FAU - Lin, Chia-Ni
AU  - Lin CN
AD  - Department of Laboratory Medicine, Chang Gung Memorial Hospital at Linkou Medical 
      Center, Taoyuan, Taiwan.
AD  - Department of Medical Biotechnology and Laboratory Science, Chang Gung 
      University, Taoyuan, Taiwan.
LA  - eng
GR  - CORPG3J0491/Chang Gung Memorial Hospital/
GR  - CORPG3J0461/Chang Gung Memorial Hospital/
PT  - Journal Article
PT  - Review
DEP - 20210322
PL  - Germany
TA  - J Neurol
JT  - Journal of neurology
JID - 0423161
RN  - 0 (Anticonvulsants)
RN  - 0 (Nitriles)
RN  - 0 (Pyridones)
RN  - H821664NPK (perampanel)
SB  - IM
MH  - *Anticonvulsants/therapeutic use
MH  - Cohort Studies
MH  - Female
MH  - Humans
MH  - Middle Aged
MH  - Nitriles
MH  - Pyridones
MH  - Retrospective Studies
MH  - *Status Epilepticus/drug therapy
OTO - NOTNLM
OT  - Modified Rankin Scale scores
OT  - Perampanel
OT  - Refractory status epilepticus
OT  - Status epilepticus
OT  - Super-refractory status epilepticus
EDAT- 2021/03/24 06:00
MHDA- 2021/09/29 06:00
CRDT- 2021/03/23 07:01
PHST- 2020/11/03 00:00 [received]
PHST- 2021/03/04 00:00 [accepted]
PHST- 2021/03/03 00:00 [revised]
PHST- 2021/03/24 06:00 [pubmed]
PHST- 2021/09/29 06:00 [medline]
PHST- 2021/03/23 07:01 [entrez]
AID - 10.1007/s00415-021-10506-9 [pii]
AID - 10.1007/s00415-021-10506-9 [doi]
PST - ppublish
SO  - J Neurol. 2021 Oct;268(10):3744-3757. doi: 10.1007/s00415-021-10506-9. Epub 2021 
      Mar 22.