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Perampanel as first line monotherapy for seizure in japan. A single-centre real-world study

Naoki Nakano1, Kouichiro Fujimoto2, Masaharu Miyauchi2

  • 1Department of Neurosurgery, Kindai University School of Medicine Address, 377-2, Ohno-Higashi, Osaka-Sayama, 589-8511, Osaka, Japan. nnakano@med.kindai.ac.jp.

Acta Neurologica Belgica
|August 17, 2025
PubMed

Insights

Perampanel (PER) monotherapy demonstrated high efficacy in epilepsy patients in Japan, with 77.8% achieving seizure freedom. This study highlights PER as an effective first-line treatment for various seizure types, even at a low dose.

Area of Science:

  • Neurology
  • Pharmacology
  • Clinical Medicine

Background:

  • National Health Insurance in Japan began covering Perampanel (PER) monotherapy in January 2020.
  • PER monotherapy was subsequently implemented as a treatment option for epilepsy at the institute.

Purpose of the Study:

  • To evaluate the efficacy of Perampanel (PER) monotherapy in Japanese patients with epilepsy.
  • To assess treatment outcomes, including seizure rates and seizure-free status, in patients receiving PER monotherapy.

Main Methods:

  • Retrospective study of 63 patients receiving PER monotherapy between January 2020 and December 2022.
  • Evaluation of seizure rate, seizure-free status, patient demographics, seizure type, and etiology.
  • Analysis of Perampanel dosage and adverse effects.

Main Results:

  • 77.8% of patients (49/63) achieved seizure freedom with Perampanel monotherapy.
  • Significant seizure reduction was observed in 12.7% (25-49% reduction) and 6.3% (50-74% reduction) of patients.
  • A median Perampanel dose of 2 mg/day was effective, with no discontinuations due to adverse effects.

Conclusions:

  • Perampanel monotherapy is effective for a broad range of seizures, particularly those associated with brain lesions.
  • Effective seizure control can be achieved with a low daily dose of Perampanel (2 mg/day).
  • Perampanel monotherapy represents a valuable treatment option for epilepsy management in Japan.
Abstract

Keywords:
EpilepsyMonotherapyOutcomePerampanel

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