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. 2022 Aug 16:18:825-832.
doi: 10.2147/TCRM.S371396. eCollection 2022.

Optimal Use of Perampanel in Elderly Asian Patients with Epilepsy: Expert Opinion

Chin-Wei Huang  1 , Kanokwan Boonyapisit  2 , Suryani Gunadharma  3 , Josephine Casanova-Gutierrez  4   5 , Liri Jin  6 , Dinesh Nayak  7 , Naoki Akamatsu  8   9
Affiliations

Optimal Use of Perampanel in Elderly Asian Patients with Epilepsy: Expert Opinion

Chin-Wei Huang et al. Ther Clin Risk Manag. .

Abstract

Managing epilepsy in the elderly remains complicated largely due to factors related to aging. In this population, management practices are increasingly shifting towards the use of newer-generation anti-seizure medications (ASMs) as they are generally associated with better tolerability and safety profiles than older ones. Perampanel is a new ASM with broad-spectrum efficacy and a favorable safety profile. However, because of the lack of information and experience in its use, the prescription of perampanel has not been optimized in the elderly in the real-world setting in Asia. A group of epilepsy experts across the region convened at a series of virtual meetings to share their experience and discuss recommendations on perampanel use in elderly patients, including dose optimization, considerations with treatment initiation, and strategies to manage adverse events and maximize tolerability. This article summarizes key clinical and real-world evidence for perampanel in the elderly and consolidates the experts' opinions on optimizing perampanel use in elderly Asian patients with epilepsy, providing practical guidance for clinicians to address challenges related to treatment initiation and tolerance.

Keywords: Asia; elderly; epilepsy; perampanel; real-world experience.

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Conflict of interest statement

Kanokwan Boonyapisit has received speaker’s honoraria from Eisai, GlaxoSmithKline, Viatris and Novartis. Josephine Casanova-Gutierrez has received speaker’s honorarium from Eisai, and is on the Board of Governors of the Philippine Neurological Association, Board of Trustees of the Philippine League Against Epilepsy and a member of the Epilepsy Council, Philippine Neurological Association. Dinesh Nayak has received speaker’s honoraria from Abbott, Cipla, Eisai, Sanofi, and Torrent Pharmaceuticals, and participated in data safety monitoring and/or advisory boards for Cipla, Dr. Reddy’s Laboratories, Eisai, Sanofi, and Torrent Pharmaceuticals. Naoki Akamatsu has received speaker’s honoraria from Daiichi Sankyo, Eisai, and UCB Japan. Chin-Wei Huang, Suryani Gunadharma and Liri Jin declare no competing interests.

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