Effectiveness of perampanel as only concomitant antiseizure medication for highly active epilepsy: insight from a real-world, multicenter retrospective study
Articolo
Data di Pubblicazione:
2025
Abstract:
Introduction: Managing patients with highly frequent seizures poses significant challenges for clinicians due to their high resistance to therapy. This study aims to evaluate the 12-month efficacy, safety, and tolerability of PER as the sole add-on therapy for patients with highly active epilepsy in a real-world setting. Methods: Data from the previous Italian retrospective, observational, multicenter “PERampanel as Only Concomitant Antiseizure Medication” (PEROC) study were analyzed, categorizing patients by baseline seizure frequency into three groups: < 5, 5–20, and > 20 seizures/month. Retention, responder (≥ 50% seizure reduction) rates, seizure-free rates and adverse events (AEs) were analyzed. Sub-analyses examined early (≤ 1 previous ASM) vs. late (> 2 previous ASMs) add-on groups. Results: The sample included 485 patients with focal and generalized epilepsy: 354 with < 5 seizures/month, 79 with 5–20, and 52 with > 20 seizures/month. Retention rates at 12 months were 75.1%, 68%, and 58.1.7%, respectively. Perampanel significantly reduced seizure frequency in all groups, with responder rates of 71.2%, 61.8%, and 63.2% at the 12-month follow-up. Patients with more frequent seizures (> 20 and 5–20 seizures/month) had lower seizure-free rates (15.8% and 23.5%) compared to those with < 5 seizures/month (49.5%, p = 0.001). AEs, mainly dizziness and irritability occurred in 30% of patients, without significant differences between groups (p = 0.092). Conclusions: PER, as the sole adjunctive therapy, demonstrated good effectiveness and tolerability in a real-world setting, even for patients with highly active epilepsy. These findings suggest PER as a valuable early treatment option to improve seizure control and quality of life in this challenging population.
Tipologia CRIS:
1.1 Articolo in rivista
Keywords:
Anti-seizure medication; Drug-refractory epilepsy; Early add-on; Real-world evidence; Seizure freedom; Very active epilepsy
Elenco autori:
Pascarella, Angelo; Pasquale, Marilisa; Abelardo, Domenico; Gasparini, Sara; Marsico, Oreste; Cutellè, Roberta; Cianci, Vittoria; Iudice, Alfonso; Bisulli, Francesca; Bonanni, Paolo; Caggia, Emanuele; D'Aniello, Alfredo; Di Bonaventura, Carlo; Difrancesco, Jacopo C.; Domina, Elisabetta; Dono, Fedele; Gambardella, Antonio; Marini, Carla; Marrelli, Alfonso; Matricardi, Sara; Morano, Alessandra; Paladin, Francesco; Renna, Rosaria; Piccioli, Marta; Striano, Pasquale; Ascoli, Michele; La Neve, Angela; Le Piane, Emilio; Orsini, Alessandro; Torino, Claudia; Beretta, Simone; Aguglia, Umberto; Ferlazzo, Edoardo; Null, Null; Arbasino, Carla; Bagnasco, Irene; Barbero, Pierangelo; Bartolini, Emanuele; Bassetti, Maria A.; Belcastro, Vincenzo; Boero, Vanni; Bonuccelli, Alice; Bulgari, Alessandro; Caggia, Emanuele; Cantello, Roberto; Casellato, Susanna; Casula, Natascia; Cesnik, Edward; Ciampa, Clotilde; Cipriani, Anna Maria; Coletti Moja, Mario; Conti, Marta; Coppola, Giangennaro; Corea, Francesco; Crichiutti, Giovanni; D'Orsi, Giuseppe; Dainese, Filippo; Danieli, Alberto; De Curtis, Marco; De Giorgis, Valentina; Del Gaudio, Luigi; Deleo, Francesco; Di Gennaro, Giancarlo; Evangelista, Giacomo; Fortunato, Francesco; Filipponi, Stefania; Gagliano, Attilio; Giacomini, Thea; Gilio, Francesca; Giordano, Alfonso; Giuliano, Loretta; Haggiag, Shalom; Jensen, Stella; Labate, Angelo; Licchetta, Laura; Lupato, Angelica; Macorig, Greta; Mammì, Anna; Mancardi, Maria Margherita; Marino, Daniela; Mostacci, Barbara; Muccioli, Lorenzo; Negrin, Susanna; Operto, Francesca; Orsini, Alessandro; Palumbo, Pasquale; Pascarella, Mariagrazia; Peretti, Alessia; Perri, Gabriella; Pustorino, Giuseppina; Ranzato, Federica; Riva, Antonella; Servo, Serena; Sammarra, Ilaria; Siri, Laura; Spitaleri, Orazio; Stabile, Andrea; Strigaro, Gionata; Varesio, Costanza
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