Efficacy And Safety Evaluation Of Perampanel In The Treatment Of Adult Epilepsy In Clinical Practice

Objective:To evaluate the clinical efficacy and safety tolerance of perampanel in the treatment of Chinese adult epilepsy patients.Methods:Clinical data of adult epileptic patients treated with perampanel in our hospital from January 2020 to December 2022 were retrospectively analyzed,including demographic and clinical characteristics of patients,changes in epileptic seizures before and after treatment with perampanel and adverse events during treatment with perampanel.To evaluate the clinical efficacy and safety of perampanel in Chinese adults with epilepsy.Results:1.A total of 69 adult epileptic patients with complete follow-up data were included,including 42 males(60.9%)and 27 females(39.1%).The median age of enrolled patients was 36 years,the median duration of epilepsy was 8 years,and the median age of onset epilepsy was 27 years.5 patients(7.2%)had a family history of epilepsy.2.Among the 69 patients,58 patients had focal epilepsy(FOS),of which 54 patients had FBTCS,11 patients had general epilepsy(GOS),and 5 patients had SE and were hospitalized.3.The enrolled epileptic patients had a dose range of 2 to 8mg,and the median therapeutic dose was 4mg.The median therapeutic dose of perampanel was 4mg in both male and female groups.The median therapeutic dose in age group≤65 years was 4mg,and the mean therapeutic dose in age group>65 years was(4.33±1.23)mg.There were 11 patients(15.9%)in the low dose 2mg group,35 patients(50.7%)in the medium dose 4mg,and 23 patients(33.3%)in the perampanel maintenance dose>4mg.4.Efficacy evaluation: The total effective rate of perampanel was 68.1%,and the seizure-free rate was 17.4%.Monotherapy or combination therapy(p =0.124),ASMs type combined(p=0.449),and perampanel additional treatment time(p=0.121)did not affect efficacy(p>0.05),and dosage may be an important factor in efficacy of perampanel(p =0.026<0.05).In addition,there was no significant difference between focal epilepsy(FOS)group and general epilepsy(GOS)group(p=0.484>0.05).5.Safety assessment: In the 69 patients treated with perampanel,36(52.2%)patients had adverse events,with an adverse reaction rate of 52.2% and a serious TEAE rate of 0.0%.The most common adverse reactions were mood change(21.7%)and dizziness(15.9%).There was no significant difference in the incidence of adverse events between monotherapy and combination therapy,early addition and late addition,combined enzyme-induced ASMs and suppressed ASMs groups(p>0.05),but there were significant differences in the incidence of adverse events between different doses of perampanel(p<0.05).Conclusions:1.In the perampanel treatment of epilepsy in Chinese adults,no matter monotherapy or additive therapy can effectively control seizures,and perampanel has a good effect on different seizure types.2.The dose of perampanel is an important factor affecting the efficacy,and low dose of 2mg can not effectively control the seizure.3.Serious adverse reactions of perampanel were rare.The most common adverse events were mood change and dizziness,most of which could be alleviated and tolerated with prolonged treatment.4.The occurrence of ADR was related to the dose of perampanel.