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Dr. Richard Shek-Kwan Chang, 11 Oct 2018
A 38-year-old right-handed man had had epilepsy since 2 months of age. There was no relevant family history. Perinatal history was unremarkable. No other risk factors such as central nervous system infection or cerebral trauma were identified. Developmental history did not show major delay. His epilepsy was uncontrolled despite trying valproate, carbamazepine, clobazam, levetiracetam, oxcarbamazepine and perampanel. 

Perampanel beneficial to both Asian, non-Asian patients with refractory focal seizures

01 Apr 2019

Perampanel is safe and effective for treating refractory focal seizures in both Asian and non‐Asian populations, a study has found.

The present analysis included data from four randomized, placebo‐controlled phase III studies involving patients aged ≥12 years who had focal seizures with or without focal to bilateral tonic‐clonic (FBTC) seizures. These patients received perampanel at a dose of 2, 4, 8 or 12 mg or placebo in two phases: 6‐week baseline period (during which perampanel doses were titrated by 2 mg/wk until randomized dose or maximum tolerated dose was reached) and maintenance phase (another 13 weeks).

A total of 2,187 randomized patients were included in the intention-to-treat population, among whom 935 were Asian and 1,247 were non‐Asian. Efficacy endpoints included median percent change in seizure frequency per 28 days, and 50-percent and seizure‐freedom responder rates relative to baseline.

The median percent change in seizure frequency per 28 days was significantly greater with perampanel vs placebo: 8-mg (−31.1 percent; p<0.0001) and 12-mg doses (−38.1 percent; p<0.0001) in the Asian population, and the 4-mg (−21.1 percent; p=0.0001), 8-mg (−26.3 percent; p<0.0001) and 12-mg doses (−27.7 percent; p=0.0001) in the non‐Asian population.

Perampanel was also superior to placebo in terms of the 50-percent responder rate, particularly the 8-mg (40.1 percent; p<0.0001) and 12-mg doses (43.8 percent; p<0.0001) in the Asian population, and the 4-mg (29.4 percent; p=0.0002), 8-mg (32.8 percent; p<0.0001) and 12-mg doses (34.5 percent; p=0.0001) in the non‐Asian population.

Seizure‐freedom rate among all patients ranged from 4.9–11.7 percent with perampanel 2, 4, 8 and 12 mg.

Dizziness, somnolence, irritability, headache and fatigue were the most frequently reported treatment‐emergent adverse events (TEAEs) across Asian and non-Asian populations. Meanwhile, the most common psychiatric TEAEs were aggression and irritability.

The present data show that perampanel has a favourable and similar risk‐benefit profile in both Asian and non‐Asian populations with refractory focal seizures, researchers said.

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Most Read Articles
Dr. Richard Shek-Kwan Chang, 11 Oct 2018
A 38-year-old right-handed man had had epilepsy since 2 months of age. There was no relevant family history. Perinatal history was unremarkable. No other risk factors such as central nervous system infection or cerebral trauma were identified. Developmental history did not show major delay. His epilepsy was uncontrolled despite trying valproate, carbamazepine, clobazam, levetiracetam, oxcarbamazepine and perampanel.