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. 2024 Feb 21;10(5):e26376.
doi: 10.1016/j.heliyon.2024.e26376. eCollection 2024 Mar 15.

Efficacy and safety of Perampanel in the treatment of post stroke epilepsy: A multicenter, real-world study

Cuihua Yan  1   2   3 , Tingting Yang  3   4 , Yuanping Sun  5 , Junji Hu  6 , Xiangming Yi  7 , Chunxiao Li  5 , Juan Chen  8 , Kunkun Wei  9 , Jing Jiang  2   3 , Qi Xiang  2   3 , Anru Liu  2   3 , Yuxiang Han  2 , Liling Yang  2 , Xiaoyun Liu  2 , Tao Han  2   3   10 , Xuewu Liu  2   3
Affiliations

Efficacy and safety of Perampanel in the treatment of post stroke epilepsy: A multicenter, real-world study

Cuihua Yan et al. Heliyon. .

Abstract

Background: Since 2019, Perampanel (PER) has been endorsed in China as an adjunctive treatment for focal seizures, both with and without impaired awareness, and for the transition from focal to bilateral tonic-clonic seizures. Limited research exists regarding the efficacy of PER in treating post-stroke epilepsy (PSE) in China. Empirical studies are essential to guide treatment protocols. We conducted a retrospective study to assess the efficacy and tolerability of PER in 58 PSE patients treated between October 2019 and July 2023.

Method: This study encompassed 58 patients with PSE, treated with PER either as monotherapy or as part of adjunctive therapy, and underwent follow-up for a minimum duration of 6 months. The study assessed changes in seizure frequency, adverse events (AEs), drug retention rate, maintenance dose, and adverse reactions following PER treatment.

Results: The study included 58 PSE patients, with 60.3% males and 39.7% females, ranging in age from 18 to 89, mostly within the 61-70 age group. Ischemic strokes constituted 58.6% of cases, while hemorrhagic strokes accounted for 41.4%. Focal seizures, either with or without impaired awareness, were noted in 62.1% of patients, and a transition from focal to bilateral tonic-clonic seizures was seen in 32.8%. The retention rates for PER at 3 and 6 months stood at 94.8% and 84.5% respectively, and the most commonly administered maintenance dose was 4 mg/day (41.28%). In the adjunctive therapy group, efficacy rates were 66.7% at 3 months and 78.6% at 6 months, compared to 80.0% at 3 months and 85.7% at 6 months in the monotherapy group. In the efficacy analysis, with a criterion of ≥50% reduction in seizure frequency, the overall efficacy rates at 3 and 6 months were 69.1% and 79.6%, respectively. Adverse reactions occurred in 46.6% of patients, primarily involving irritability and somnolence (both 27.6%), with no marked difference in incidence between the adjunctive and monotherapy groups (P > 0.05).

Conclusion: PER exhibits favorable efficacy and tolerability in Chinese PSE patients, possibly at lower doses.

Keywords: Clinical efficacy; Perampanel; Post-stroke epilepsy; Safety.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Changes in seizure frequency and medication status at 3 and 6 months of PER treatment. Note: * Seizure frequency change controlled at <100% and ≥50%, ** Seizure frequency change controlled at <50%.
Fig. 2
Fig. 2
The overall retention rate of PER in 58 patients.
Fig. 3
Fig. 3
The maintenance dosage of PER in patients at the 6-month follow-up.
Fig. 4
Fig. 4
AEs associated with PER treatment.
See this image and copyright information in PMC

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