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Tolerability and efficacy of perampanel in children with refractory epilepsy
Eli Heyman1,2, Eli Lahat1,2, Noa Levin1
1Department of Pediatric Neurology, Assaf Harofeh Medical Center, Zerifin, Israel.
Insights
Perampanel, an antiepileptic drug, showed efficacy in reducing seizures in some children with refractory epilepsy. However, adverse events, particularly behavioral issues in adolescents, were common, leading to discontinuation in many cases.
Area of Science:
- Pediatric Neurology
- Pharmacology
- Epilepsy Research
Background:
- Limited data exists on perampanel's tolerability and efficacy in pediatric populations.
- Perampanel is a novel antiepileptic drug targeting a specific mechanism of action.
Purpose of the Study:
- To evaluate the real-world experience of perampanel as add-on and mono-therapy in children with refractory epilepsy.
- To assess the tolerability and efficacy of perampanel in pediatric patients.
Main Methods:
- Retrospective review of computerized medical records.
- Inclusion of pediatric patients treated with perampanel between December 2012 and October 2015.
- Analysis of adverse events, seizure reduction, and treatment discontinuation.
Main Results:
- Twenty-four children (aged 1.5-17 years) were included.
- Adverse events were more frequent in older children (89% vs 53%), mainly behavioral.
- Significant seizure reduction (≥50%) was observed in 42% of patients; 54% discontinued perampanel due to adverse events.
Conclusions:
- Perampanel demonstrates efficacy in a subset of children with refractory epilepsy.
- High rates of behavioral adverse events, especially in adolescents, necessitate careful monitoring.
- Treatment discontinuation due to adverse events is common in this pediatric population.
Aim:
There are few reports on the tolerability and efficacy of perampanel, a new antiepileptic drug with a novel mechanism of action, in children and adolescents. We aimed to describe our experience with perampanel add-on and mono-therapy in children with refractory epilepsy.
Method:
Computerized medical records of children treated with perampanel in the paediatric neurology clinic from December 2012 to October 2015 were reviewed.
Results:
Twenty-four children treated with perampanel (15 females, 9 males) aged 1 year 6 months to 17 years (mean 10y, standard deviation [SD] 4y 5mo) were identified. Adverse events were more common in children aged 12 years or older (89%) compared to younger children (53%), and were mainly behavioural. Ten (42%) children had 50 per cent or higher seizure reduction, two (8%) children had 33 per cent seizure reduction, and seizures were less severe in one (4%) child. Perampanel was discontinued in 13 (54%) children mostly due to adverse events. The mean duration of follow-up in the remaining 11 children was 8.1 months (SD 5.2) (range 1.3-17mo).
Interpretation:
Perampanel is associated with a relatively high rate of behavioural adverse events mostly in adolescents with refractory epilepsy.
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