Abstracts

Rationale: Perampanel (PER) has recently become available as a novel antiepileptic drug for add-on treatment of partial-onset seizures. The mechanism of action of Perampanel is new and consists of non-competitive blockade of AMPA-currents. First experiences regarding efficacy and tolerability of using PER as an add-on treatment are reported.Methods: Retrospective analysis of electronic charts of 38 patients (23 male, age 12-73 y/mean 37 y) with focal epilepsy newly undergoing add-on treatment with Perampanel. Efficacy was assesses based on seizure frequency and type as documented in patient diaries, tolerability based on subjective patient complaints and clinical investigations during follow-up visits. The analysis was restricted to patients with at least one clinical contact following PER-introduction.Results: All patients received PER as a once daily dose late during the night. Initial target dose was 4 mg with later increase in dosage depending on seizure control and tolerability. Median last dose of patients undergoing treatment at the time of this interim analysis was 5mg/day. 50 % of patients showed a relevant improvement in seizure control (seizure reduction by >50% and/or cessation of severe seizure types). Effects on seizure control in responders were frequently seen already at a dose of 4 mg. 19/38 patients reported any side effects at the dosages applied. Most frequent side effects consisted of tiredness and/or dizziness 1 hour after drug intake but only in a few cases followed by accompanied by daytime sleepiness; dizziness and rare psychiatric side effects (aggressiveness in 1 patient, depression in 2 patients) were found to be subjectively most relevant side effects. There were no patient complaints on cognitive impairment. In 6/38 patients side effects resulted in dose reduction or complete tapering of PER. Conclusions: Add-on therapy with PER showed efficacy in about half of the patients treated, with significant effects also in particularly difficult-to-treat epilepsies. Seizure severity was frequently reported to decrease during PER treatment. Overall tolerability with late once daily intake was good.