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Perampanel in routine clinical use in idiopathic generalized epilepsy: The 12‐month GENERAL study
Author(s) -
Villanueva Vicente,
Montoya Javier,
Castillo Ascension,
MauriLlerda José Á.,
Giner Pau,
LópezGonzález Francisco J.,
Piera Anna,
VillanuevaHernández Pedro,
Bertol Vicente,
GarciaEscrivá Alejandro,
GarciaPeñas Juan J.,
Garamendi Iñigo,
EsteveBelloch Patricia,
BaigesOctavio Juan J.,
Miró Júlia,
Falip Mercè,
Garcés Mercedes,
Gómez Asier,
GilLópez Francisco J.,
Carreño Mar,
RodriguezUranga Juan J.,
Campos Dulce,
Bonet Macarena,
Querol Rosa,
Molins Albert,
Tortosa Diego,
SalasPuig Javier
Publication year - 2018
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/epi.14522
Subject(s) - perampanel , idiopathic generalized epilepsy , epilepsy , juvenile myoclonic epilepsy , medicine , pediatrics , tolerability , irritability , epilepsy syndromes , anesthesia , population , lamotrigine , generalized epilepsy , adverse effect , somnolence , psychiatry , environmental health , menopause
Summary Objective To analyze the effectiveness and tolerability of perampanel across different seizure types in routine clinical care of patients with idiopathic generalized epilepsy ( IGE ). Methods This multicenter, retrospective, 1‐year observational study collected data from patient records at 21 specialist epilepsy units in Spain. All patients who were aged ≥12 years, prescribed perampanel before December 2016, and had a confirmed diagnosis of IGE were included. Results The population comprised 149 patients with IGE (60 with juvenile myoclonic epilepsy, 51 generalized tonic–clonic seizures [ GTCS ] only, 21 juvenile absence epilepsy, 10 childhood absence epilepsy, 6 adulthood absence epilepsy, and one Jeavons syndrome). Mean age was 36 years. The retention rate at 12 months was 83% (124/149), and 4 mg was the most common dose. At 12 months, the seizure‐free rate was 59% for all seizures (88/149); 63% for GTCS (72/115), 65% for myoclonic seizures (31/48), and 51% for absence seizures (24/47). Seizure frequency was reduced significantly at 12 months relative to baseline for GTCS (78%), myoclonic (65%), and absence seizures (48%). Increase from baseline seizure frequency was seen in 5.2% of patients with GTCS seizures, 6.3% with myoclonic, and 4.3% with absence seizures. Perampanel was effective regardless of epilepsy syndrome, concomitant antiepileptic drugs ( AEDs ), and prior AED s, but retention and seizure freedom were significantly higher when used as early add‐on (after ≤2 prior AED s) than late (≥3 prior AED s). Adverse events were reported in 50% of patients over 12 months, mostly mild or moderate, and irritability (23%), somnolence (15%), and dizziness (14%) were most frequent. Significance In routine clinical care of patients with IGE , perampanel improved seizure outcomes for GTCS , myoclonic seizures, and absence seizures, with few discontinuations due to adverse events. This is the first real‐world evidence with perampanel across different seizure types in IGE .