PMID- 38434369 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240305 IS - 2405-8440 (Print) IS - 2405-8440 (Electronic) IS - 2405-8440 (Linking) VI - 10 IP - 5 DP - 2024 Mar 15 TI - Efficacy and safety of Perampanel in the treatment of post stroke epilepsy: A multicenter, real-world study. PG - e26376 LID - 10.1016/j.heliyon.2024.e26376 [doi] LID - e26376 AB - BACKGROUND: Since 2019, Perampanel (PER) has been endorsed in China as an adjunctive treatment for focal seizures, both with and without impaired awareness, and for the transition from focal to bilateral tonic-clonic seizures. Limited research exists regarding the efficacy of PER in treating post-stroke epilepsy (PSE) in China. Empirical studies are essential to guide treatment protocols. We conducted a retrospective study to assess the efficacy and tolerability of PER in 58 PSE patients treated between October 2019 and July 2023. METHOD: This study encompassed 58 patients with PSE, treated with PER either as monotherapy or as part of adjunctive therapy, and underwent follow-up for a minimum duration of 6 months. The study assessed changes in seizure frequency, adverse events (AEs), drug retention rate, maintenance dose, and adverse reactions following PER treatment. RESULTS: The study included 58 PSE patients, with 60.3% males and 39.7% females, ranging in age from 18 to 89, mostly within the 61-70 age group. Ischemic strokes constituted 58.6% of cases, while hemorrhagic strokes accounted for 41.4%. Focal seizures, either with or without impaired awareness, were noted in 62.1% of patients, and a transition from focal to bilateral tonic-clonic seizures was seen in 32.8%. The retention rates for PER at 3 and 6 months stood at 94.8% and 84.5% respectively, and the most commonly administered maintenance dose was 4 mg/day (41.28%). In the adjunctive therapy group, efficacy rates were 66.7% at 3 months and 78.6% at 6 months, compared to 80.0% at 3 months and 85.7% at 6 months in the monotherapy group. In the efficacy analysis, with a criterion of >/=50% reduction in seizure frequency, the overall efficacy rates at 3 and 6 months were 69.1% and 79.6%, respectively. Adverse reactions occurred in 46.6% of patients, primarily involving irritability and somnolence (both 27.6%), with no marked difference in incidence between the adjunctive and monotherapy groups (P > 0.05). CONCLUSION: PER exhibits favorable efficacy and tolerability in Chinese PSE patients, possibly at lower doses. CI - (c) 2024 The Authors. Published by Elsevier Ltd. FAU - Yan, Cuihua AU - Yan C AD - Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, PR China. AD - Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, PR China. AD - Institute of Epilepsy, Shandong University, Jinan, Shandong, PR China. FAU - Yang, Tingting AU - Yang T AD - Institute of Epilepsy, Shandong University, Jinan, Shandong, PR China. AD - Department of Neurology, Qilu Hospital of Shandong University, Jinan, Shandong, PR China. FAU - Sun, Yuanping AU - Sun Y AD - Qingdao University Affiliated Hospital, Qingdao, Shandong, PR China. FAU - Hu, Junji AU - Hu J AD - Department of Neurology, Zibo Changguo Hospital, Zibo, Shandong, PR China. FAU - Yi, Xiangming AU - Yi X AD - Binzhou Medical College Affiliated Hospital, Binzhou, Shandong, PR China. FAU - Li, Chunxiao AU - Li C AD - Qingdao University Affiliated Hospital, Qingdao, Shandong, PR China. FAU - Chen, Juan AU - Chen J AD - The Third People's Hospital of Heze City, Heze, Shandong, PR China. FAU - Wei, Kunkun AU - Wei K AD - Qingdao Women and Children's Hospital, Qingdao, Shandong, PR China. FAU - Jiang, Jing AU - Jiang J AD - Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, PR China. AD - Institute of Epilepsy, Shandong University, Jinan, Shandong, PR China. FAU - Xiang, Qi AU - Xiang Q AD - Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, PR China. AD - Institute of Epilepsy, Shandong University, Jinan, Shandong, PR China. FAU - Liu, Anru AU - Liu A AD - Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, PR China. AD - Institute of Epilepsy, Shandong University, Jinan, Shandong, PR China. FAU - Han, Yuxiang AU - Han Y AD - Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, PR China. FAU - Yang, Liling AU - Yang L AD - Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, PR China. FAU - Liu, Xiaoyun AU - Liu X AD - Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, PR China. FAU - Han, Tao AU - Han T AD - Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, PR China. AD - Institute of Epilepsy, Shandong University, Jinan, Shandong, PR China. AD - Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, PR China. FAU - Liu, Xuewu AU - Liu X AD - Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, PR China. AD - Institute of Epilepsy, Shandong University, Jinan, Shandong, PR China. LA - eng PT - Journal Article DEP - 20240221 PL - England TA - Heliyon JT - Heliyon JID - 101672560 PMC - PMC10907510 OTO - NOTNLM OT - Clinical efficacy OT - Perampanel OT - Post-stroke epilepsy OT - Safety COIS- The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2024/03/04 06:47 MHDA- 2024/03/04 06:48 PMCR- 2024/02/21 CRDT- 2024/03/04 04:44 PHST- 2023/10/30 00:00 [received] PHST- 2024/02/10 00:00 [revised] PHST- 2024/02/12 00:00 [accepted] PHST- 2024/03/04 06:48 [medline] PHST- 2024/03/04 06:47 [pubmed] PHST- 2024/03/04 04:44 [entrez] PHST- 2024/02/21 00:00 [pmc-release] AID - S2405-8440(24)02407-1 [pii] AID - e26376 [pii] AID - 10.1016/j.heliyon.2024.e26376 [doi] PST - epublish SO - Heliyon. 2024 Feb 21;10(5):e26376. doi: 10.1016/j.heliyon.2024.e26376. eCollection 2024 Mar 15.