The Efficacy and Safety of Perampanel Use in Patients with Refractory Status Epilepticus at a Single Center in the United Arab Emirates (UAE)
Abstract number :
1.384
Submission category :
18. Case Studies
Year :
2021
Submission ID :
1826233
Source :
www.aesnet.org
Presentation date :
12/4/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:52 AM
Authors :
Rita Jebrin, PharmD - Cleveland Clinic Abu dhabi; Karan Poddar - Staff Physician Neurology and Epilepsy, Department of Neurology, Cleveland Clinic Abu dhabi
Rationale: Perampanel (PER) is a novel oral antiepileptic drug that works as a noncompetitive AMPA receptor antagonist that was initially approved in 2012 as adjunctive treatment for partial onset seizures. Subsequently it has been approved as adjunctive treatment for primary generalized tonic-clonic seizures, and in 2017 as monotherapy for partial onset seizures with or without secondary generalized seizures. We reviewed the use of oral PER in adult patients with refractory status epilepticus (RSE).
Methods: We studied patients who received oral PER for RSE at our quaternary care hospital from January 2019 until January 2021. RSE was defined as status epilepticus that continues despite treatment with benzodiazepines and one or more antiepileptic drugs (AEDs). Review of patients’ electronic medical records was performed. The primary objective was defined as > 50% improvement in clinical or electrographic seizures within 24-48 hours of PER initiation. Definite improvement was defined as > 50% reduction in seizure frequency, likely improvement was defined as the ability to wean off sedation after receiving PER, while no improvement was defined as < 50% reduction or no change in seizure activity.
Results: Ten patients with refractory epilepsy or cluster seizures who received PER for more than 24 hours were reviewed so far. Mean age was 52.4 years (range: 15 years to 80 years). 100% of patients were receiving 2 or more antiepileptic agents before starting PER (in addition to benzodiazepine). The mean initial or loading dose was 9 mg. The average maintenance dose was 8 mg. PER was found to have definite improvement in 4/10 (40%) patients. Of those (75%) became seizure free. Two patients (20%) had no improvement within 24 hours of PER administration and 40% likely improved, with no recurrence of seizures after weaning off sedation. Only self-limiting somnolence and ataxia were reported in 3 patients receiving PER.
Conclusions: Perampanel was found to be an effective add-on treatment for RSE even in patients who failed multiple AEDs. Eighty percent of the patients showed improvement and thirty percent became seizure free with no significant adverse events.
Funding: Please list any funding that was received in support of this abstract.: None.
Case Studies