Intravenous perampanel in clinical practice: A multicenter prospective registry study

Area of Science:

• Neurology
• Clinical Pharmacology
• Epileptology

Background:

• Epileptic seizures require effective acute management.
• Intravenous antiepileptic drugs are crucial for rapid seizure control.
• Perampanel has shown efficacy in chronic epilepsy, but its acute use needs evaluation.

Purpose of the Study:

• To assess the efficacy and safety of intravenous perampanel (IV-PER) in routine clinical practice.
• To determine seizure suppression rates within 7 days of IV-PER initiation.
• To evaluate adverse events associated with IV-PER in an acute setting.

Main Methods:

• A prospective registry study included 237 patients receiving IV-PER across 22 institutions.
• Patients were categorized by etiology: cerebrovascular disease (CD), brain tumor (BT), and traumatic brain injury (TBI).
• Primary endpoint: seizure suppression rate within 7 days; Secondary endpoint: adverse events (AEs).

Main Results:

• Overall seizure suppression rate within 7 days was 89.0%.
• Suppression rates varied by etiology: 87.8% (CD), 96.6% (BT), 72.3% (TBI).
• Common AEs included somnolence and irritability; laboratory abnormalities were also noted in 71 patients.

Conclusions:

• Intravenous perampanel (IV-PER) demonstrates significant efficacy in seizure management during the acute phase.
• IV-PER is a safe treatment option in real-world clinical settings for various etiologies.
• The study supports the use of IV-PER for acute seizure control in hospitalized patients.