Initial therapeutic target attainment of perampanel in pediatric patients with epilepsy
Lingyan Yu1, Meng Chen1, Jieqiong Liu2
1Department of Pharmacy, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
Insights
Perampanel shows good initial target attainment in pediatric epilepsy patients in China. Routine therapeutic drug monitoring may not be needed unless enzyme-inductive antiepileptic drugs are used concurrently.
Area of Science:
- Pharmacology and Therapeutics
- Pediatric Neurology
- Clinical Pharmacy
Background:
- Perampanel is an antiepileptic drug (AED) with variable plasma concentrations in pediatric patients.
- Optimizing perampanel dosage is crucial for effective epilepsy management in children.
Purpose of the Study:
- To evaluate the initial target attainment of perampanel plasma concentration in Chinese pediatric epilepsy patients.
- To identify factors influencing perampanel concentration achievement in this population.
Main Methods:
- Retrospective analysis of 137 pediatric epilepsy patients treated between January 2020 and December 2021.
- Collection of demographic data, dosing strategies, and therapeutic drug monitoring (TDM) results.
- Statistical analysis to determine target attainment rates and associated risk factors.
Main Results:
- 89.8% of pediatric patients achieved suitable perampanel plasma concentrations (100-1,000 ng/mL).
- Concomitant use of enzyme-inductive AEDs was the sole significant risk factor for nonattainment (OR = 5.92).
- Wide inter-individual variability in perampanel concentrations was observed (60-1,560 mg/L).
Conclusions:
- Initial perampanel target attainment is satisfactory in Chinese pediatric epilepsy patients.
- Routine therapeutic drug monitoring for perampanel may be unnecessary for most patients.
- TDM is recommended for pediatric patients receiving perampanel concurrently with enzyme-inductive AEDs.
Abstract:
Perampanel is a promising option for the treatment of pediatric epilepsy, but its plasma concentration varies among patients. This retrospective study aimed to investigate the initial target attainment of perampanel plasma concentration in pediatric patients with epilepsy in China. Inpatients admitted from January 2020 to December 2021 in a tertiary hospital were retrospectively included according to pre-set criteria. Demographic characteristics of patients and dosing strategies and therapeutic drug monitoring results were collected. A total of 137 pediatric patients (84 females and 53 males, aged from 0.6 to 16.4 years) were include for analysis. The perampanel concentrations varied greatly from 60 to 1,560 mg/L among patients, but 89.8% had suitable perampanel concentrations (100-1,000 ng/mL). The concomitant use of enzyme-inductive antiepileptic drugs (AEDs) was the only identified risk factor associated with target nonattainment (OR = 5.92, 95% confidence interval 1.68-20.9). Initial perampanel target attainment in pediatric patients is satisfactory. Routine therapeutic drug monitoring to achieved the suggested concentration range for these patients may be unnecessary, except for those receiving combined enzyme inductive AEDs.
More Related Videos
Related Concept Videos
01:14Antiepileptic Drugs: Glutamate Antagonists
01:20Antiepileptic Drugs: Modulators of Neurotransmitter Release Mediated by SV2A Protein
SV2A is a transmembrane glycoprotein located predominantly in the brain, modulating the release of neurotransmitters for neuronal communication. Both levetiracetam and brivaracetam exhibit a high affinity for...
01:20Antiepileptic Drugs: Potassium Channel Activators
Ezogabine has gained approval as an adjunctive treatment...
01:18Antiepileptic Drugs: GABAergic Pathway Potentiators
The key GABA pathway potentiators used in epilepsy management are as follows.
Benzodiazepines are a well-known class of drugs used for...