Long-term Effectiveness and Safety of Perampanel Monotherapy in Epilepsy and Sleep-related Seizures: A Multicenter Real-world Experience
Abstract number :
3.435
Submission category :
7. Anti-seizure Medications / 7E. Other
Year :
2024
Submission ID :
442
Source :
www.aesnet.org
Presentation date :
12/9/2024 12:00:00 AM
Published date :
Authors :
Presenting Author: Yun Ho Choi, MD – Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Republic of Korea
Hye-Rim Shin, MD – Dankook University Hospital, Cheonan, Republic of Korea.
Hee-Jin Im, MD – Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea.
Kyoung Jin Hwang, MD – Kyung Hee University School of Medicine, Seoul, Republic of Korea
Hyun-Woo Kim, MD – Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.
Jung Bin Kim, MD, PhD – Korea University Anam Hospital, Korea University College of Medicine
Jee Hyun Kim, MD, PhD – Ewha Womans University Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
Won-Joo Kim, MD, PhD – Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
Rationale: This study aims to evaluate the long-term effectiveness and tolerability of perampanel monotherapy in patients with focal or generalized epilepsy, with a specific focus on those experiencing sleep-related seizures in real-world clinical settings.
Methods: This retrospective, non-interventional, multicenter study enrolled patients aged ≥15 years diagnosed with focal or generalized epilepsy who were treated with perampanel. Evaluations of efficacy, tolerability, and safety were conducted at 3, 6, 12, 24, and 36 months. Patients were divided into monotherapy and add-on therapy groups based on their treatment regimens. Additionally, a comparative analysis was conducted on a subgroup of patients with predominantly or exclusively sleep-related seizures. The retention rates were estimated by Kaplan-Meier analysis.
Results: A total of 551 patients (mean age 47.8 years, 54.4% men) were included in the study. Of these, 88 patients (mean age 49.9 years, 62.5% men) were on perampanel monotherapy, and 92 patients (mean age 42.8 years, 68.5% men) had sleep-related epilepsy. Perampanel monotherapy demonstrated significant effectiveness and tolerability in patients with focal or generalized epilepsy. The responder rates, defined as a 75% reduction in seizure frequency, for monotherapy at 6, 12, 24, and 36 months were 81.2%, 75.0%, 70.0%, and 55.6%, respectively, compared to 54.1%, 60.2%, 47.3%, and 47.6% for add-on therapy. Retention rates for monotherapy at 3, 6, 12, 24, and 36 months were 80.6%, 75.7%, 75.7%, 74.4%, and 74.4%, respectively, versus 76.8%, 70.2%, 67.8%, 64.4%, and 55.8% for add-on therapy. Although there was no statistically significant difference in the subgroup of patients with sleep-related epilepsy, both efficacy and tolerability were generally better in the monotherapy group. Treatment-emergent adverse events were reported in 44.3% of the patients, with the most common being dizziness (15.9%) and somnolence (12.5%), which were mostly mild to moderate in severity.
Conclusions: Perampanel monotherapy is an effective and well-tolerated treatment option for patients with focal and generalized epilepsy, including those with sleep-related seizures. This study supports the use of perampanel monotherapy as a practical approach for long-term management of epilepsy in real-world clinical practice.
Funding: None
Anti-seizure Medications