PMID- 37056989
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230415
IS  - 1663-9812 (Print)
IS  - 1663-9812 (Electronic)
IS  - 1663-9812 (Linking)
VI  - 14
DP  - 2023
TI  - Efficacy and tolerability of perampanel in patients with seizures in real-world 
      clinical practice: A systematic review and meta-analysis.
PG  - 1139514
LID - 10.3389/fphar.2023.1139514 [doi]
LID - 1139514
AB  - Objectives: The aim of this study was to systematically review the efficacy and 
      tolerability of perampanel (PER) when used as add-on treatment or monotherapy in 
      patients with epilepsy aged 12 years and older in routine clinical practice. 
      Methods: Electronic and clinical trials databases were searched for observational 
      studies of PER published up to 1 March 2022. The outcomes of interest were 
      responder rates, adverse effects (AEs), and withdrawal rates. Subgroup analyses 
      were performed to explore the potential factors that might affect the efficacy 
      and safety of PER usage. Results: A total of 56 studies, which included 10,688 
      patients, were enrolled. The results showed that after 3, 6, and 12 months of PER 
      treatment, the pooled 50% responder rates in patients with epilepsy were 50.0% 
      (95% CI: 0.41-0.60), 44.0% (95% CI: 0.38-0.50), and 39.0% (95% CI: 0.31-0.48), 
      respectively, and the pooled seizure-free rates were 24.0% (95% CI: 0.17-0.32), 
      21.0% (95% CI: 0.17-0.25), and 20.0% (95% CI: 0.16-0.24), respectively. Subgroup 
      analyses revealed that the efficacy of PER could be affected by the way in which 
      PER is administrated. Patients in the groups where PER was used as the first 
      add-on, primary monotherapy, or combined with non-enzyme-inducing AEDs 
      (non-EIAEDs) displayed a high 50% responder rate and seizure-free rate when 
      compared with those in the late add-on, conversion therapy, or combined with the 
      EIAEDs groups, respectively. Furthermore, the incidences of AEs at 3, 6, and 
      12 months of PER treatment were 46% (95% CI: 0.38-0.55), 52.0% (95% CI: 
      0.43-0.60), and 46.0% (95% CI: 0.40-0.52), respectively. The withdrawal rates due 
      to AEs were 8.0% (95% CI: 0.06-0.11), 16.0% (95% CI: 0.13-0.20), and 16% (95% CI: 
      0.11-0.21) at 3, 6, and 12 months of PER treatment, respectively. Subgroup 
      analyses showed a higher withdrawal rate in the rapid (30%, 95% CI: 0.22-0.38) 
      than in the slow (12%, 95% CI: 0.06-0.18) titration group. Conclusion: 
      Altogether, PER was effective and could be fairly tolerated in both short-term 
      and long-term usage in patients with epilepsy in routine clinical practice. 
      Furthermore, PER appeared to be more effective when PER was used as the first 
      add-on, monotherapy, or concomitant with non-EIAEDs. Systematic Review 
      Registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022384532.
CI  - Copyright (c) 2023 Hou, Yang, Zhang, Li, Li, Zhang, Zhao and Wang.
FAU - Hou, Liyan
AU  - Hou L
AD  - Dalian Medical University Library, Dalian Medical University, Dalian, China.
FAU - Yang, Jingjing
AU  - Yang J
AD  - Department of Neurology, The First Affiliated Hospital of Dalian Medical 
      University, Dalian, China.
FAU - Zhang, Xuan
AU  - Zhang X
AD  - National-Local Joint Engineering Research Center for Drug-Research and 
      Development R & D of Neurodegenerative Diseases, Dalian Medical University, 
      Dalian, China.
FAU - Li, Na
AU  - Li N
AD  - National-Local Joint Engineering Research Center for Drug-Research and 
      Development R & D of Neurodegenerative Diseases, Dalian Medical University, 
      Dalian, China.
FAU - Li, Sheng
AU  - Li S
AD  - National-Local Joint Engineering Research Center for Drug-Research and 
      Development R & D of Neurodegenerative Diseases, Dalian Medical University, 
      Dalian, China.
FAU - Zhang, Lei
AU  - Zhang L
AD  - Dalian Medical University Library, Dalian Medical University, Dalian, China.
FAU - Zhao, Jie
AU  - Zhao J
AD  - National-Local Joint Engineering Research Center for Drug-Research and 
      Development R & D of Neurodegenerative Diseases, Dalian Medical University, 
      Dalian, China.
FAU - Wang, Qingshan
AU  - Wang Q
AD  - National-Local Joint Engineering Research Center for Drug-Research and 
      Development R & D of Neurodegenerative Diseases, Dalian Medical University, 
      Dalian, China.
AD  - School of Public Health, Dalian Medical University, Dalian, China.
LA  - eng
PT  - Systematic Review
DEP - 20230328
PL  - Switzerland
TA  - Front Pharmacol
JT  - Frontiers in pharmacology
JID - 101548923
PMC - PMC10086234
OTO - NOTNLM
OT  - meta-analysis
OT  - perampanel
OT  - real-world study
OT  - seizures
OT  - systemic review
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2023/04/15 06:00
MHDA- 2023/04/15 06:01
PMCR- 2023/03/28
CRDT- 2023/04/14 02:35
PHST- 2023/01/07 00:00 [received]
PHST- 2023/03/13 00:00 [accepted]
PHST- 2023/04/15 06:01 [medline]
PHST- 2023/04/14 02:35 [entrez]
PHST- 2023/04/15 06:00 [pubmed]
PHST- 2023/03/28 00:00 [pmc-release]
AID - 1139514 [pii]
AID - 10.3389/fphar.2023.1139514 [doi]
PST - epublish
SO  - Front Pharmacol. 2023 Mar 28;14:1139514. doi: 10.3389/fphar.2023.1139514. 
      eCollection 2023.