First add-on perampanel for focal-onset seizures: An open-label, prospective study

Area of Science:

• Neurology
• Pharmacology
• Clinical Trials

Background:

• Focal-onset seizures, with or without secondary generalization, represent a significant challenge in epilepsy management.
• Current treatment strategies often involve add-on therapies to monotherapy to achieve seizure control.

Purpose of the Study:

• To evaluate the efficacy and safety of perampanel as an add-on therapy to monotherapy in patients with focal-onset seizures.
• To assess responder rates (50%, 75%, 100% seizure reduction) and treatment-emergent adverse events (TEAEs).

Main Methods:

• A multicentre, open-label trial involving patients with focal-onset seizures treated with perampanel monotherapy.
• A 12-week titration period followed by a 24-week maintenance period.
• Post hoc analysis explored the impact of titration speed and concomitant antiepileptic drugs (AEDs).

Main Results:

• 80.0% of patients achieved at least 50% seizure reduction; 71.8% achieved 75% reduction, and 47.1% achieved 100% reduction.
• In patients with secondarily generalized tonic-clonic seizures, response rates were high: 87.5% for 50% and 75% reduction, and 75.0% for 100% reduction.
• Common TEAEs included dizziness (50.0%), somnolence (9.8%), and headache (8.8%). Slow titration improved efficacy and safety.

Conclusions:

• Perampanel is an effective and well-tolerated first add-on therapy for focal-onset seizures.
• The drug's efficacy and safety profile are favorable, particularly with slower titration schedules.