Abstracts

Rationale: Perampanel (PER) is a once daily antiepileptic drug with a very long half-life (105 hours) and a novel mechanism acting as a non-competitive antagonist of AMPA receptors of glutamate. PER is approved for the treatment of focal seizures with or without secondary generalization and primary generalized tonic-clonic seizures. Due to its characteristics it is suitable to use it as first add-on and monotherapy but there is still a need of real world data evidence within this context. Methods: Single-center observational and retrospective study of patients with focal and generalized epilepsy treated with PER as first add-on or monotherapy according to daily clinical practice performed in Toledo, Spain. Data at 3, 6 and 12 months was recorded. Here we present preliminary results of efficacy and tolerability. Results: A total of 28 patients have been included so far, of which 24 patients were treated with PER as first add-on and 4 patients with PER monotherapy. Mean age was 46.2 years-old and 18 were women. 64.3% of patients had focal epilepsy and 35.7% generalized epilepsy. Median dose of PER at 3, 6 and 12 months was 4 [2, 6], 6 [4, 8] and 6 [4, 8] mg/day respectively. After 3 months, 24 patients had follow up data of which 17 were responders (70.8%) including 11 patients free of seizures (45.8%).  At 6 months, from 21 patients with follow up data, 12 were both responders and seizure free (57.1%). After 12 months there was follow up data from 19 patients of which 11 patients were responders (57.9%) including 9 patients free of any seizure (47.4%). Adverse events (AEs) occurred in 36.8% of patients after 3 and 6 months and in 10.5% after 12 months. However, most AEs were considered mild and led to discontinuation only in 2 patients, 1 after 6 months and 1 after 12 months of PER treatment. Most frequent AEs were somnolence (3 patients) followed by dizziness (2 patients) and headache (2 patients). Conclusions: PER has shown efficacy in focal and generalized seizures as first add-on treatment and monotherapy, with high seizure freedom rates. PER has also proven in this study its good tolerability profile with most AEs considered mild. Due to its broad spectrum and novel mechanism of action PER is a suitable option for early treatment of epilepsy patients. Funding: None