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Real-world hospitalization risk in patients with epilepsy treated with perampanel
Xuan Li1, Feride Frech1, Craig A Plauschinat1
1Eisai Inc., 100 Tice Blvd, Woodcliff Lake, NJ 07677, USA.
Insights
Adherence to perampanel treatment significantly reduced epilepsy-related hospitalizations and emergency department visits in a real-world study. This highlights the importance of medication adherence for patients with epilepsy.
Area of Science:
- Epilepsy treatment and patient outcomes
- Pharmacovigilance and real-world evidence studies
Background:
- Perampanel is an antiepileptic drug used for seizure management.
- Understanding the real-world risks associated with initiating perampanel is crucial for clinical decision-making.
Purpose of the Study:
- To evaluate the risk of hospitalization and emergency department (ED) visits after starting perampanel treatment in epilepsy patients.
- To assess the impact of medication adherence on these risks.
Main Methods:
- Retrospective longitudinal cohort study using the Optum® Clinformatics® Datamart.
- Included patients aged 4-11 years with partial onset seizures or ≥12 years with primary generalized tonic-clonic seizures, with perampanel prescription between 2014-2018.
- Assessed one-year relative risks of hospitalizations and ED visits, comparing overall population with a subset adherent to treatment (Medication Possession Ratio [MPR] ≥80%).
Main Results:
- No significant difference in hospitalization or ED visit risks in the overall study population post-perampanel initiation.
- Among adherent patients (MPR ≥80%), perampanel initiation was associated with significantly lower risks of epilepsy-related hospitalization (RR=0.68), all-cause ED visits (RR=0.80), and epilepsy-related ED visits (RR=0.74).
- Confidence intervals for these reductions were statistically significant.
Conclusions:
- Medication adherence to perampanel is strongly associated with reduced hospitalization and ED visit risks in real-world epilepsy management.
- Promoting adherence may improve patient outcomes and reduce healthcare resource utilization.
Aim:
The aim of this study was to evaluate the risk of hospitalization and emergency department admission following initiation of perampanel treatment in patients with epilepsy.
Methods:
This study is a retrospective longitudinal cohort study (Optum® Clinformatics® Datamart). Patients 4 to 11 years of age with a diagnosis of partial onset seizures or ≥12 years of age with primary generalized tonic-clonic seizures who had ≥1 perampanel prescription between 1/1/2014 and 3/31/2018 were eligible for the study. Additionally, patients were required to have 12-months of continuous enrollment before (pre-) and after (post-) the date of the first perampanel prescription (index-date). One-year relative-risks of all-cause and epilepsy-related hospitalizations and emergency department (ED) visits were estimated following initiation of perampanel treatment. Outcomes were also evaluated among a subsets of patients who were adherent to perampanel treatment, defined as a Medication Possession Ratio (MPR) ≥80%.
Results:
A total of 320 patients were included in the study, mean age 38.2 ± 19 years, 56.6% female. In the overall population, the relative risks of hospitalizations or ED visits after perampanel initiation were not significantly different. Among the 145 patients who had an MPR ≥80%, initiation of perampanel treatment resulted in a significantly lower risk of epilepsy-related hospitalization (relative risk [RR] = 0.68, confidence interval [CI] [0.47, 0.98]), all-cause ED visits (RR = 0.80, CI [0.66, 0.98]), and epilepsy-related ED visits (RR = 0.74, CI [0.57, 0.95]) in the follow-up period.
Conclusions:
Adherence to perampanel treatment was associated with significant reductions in one-year hospitalizations and ED visit risk in real world settings.
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