Abstracts

Rationale: Elderly adults >60 years have a high incidence of epilepsy and seizure recurrence. Choice of antiepileptic drug (AED) in this group is influenced by seizure type, tolerability and comorbidities. Real-life data were used to investigate treatment response and adverse events (AEs) with perampanel in the elderly versus a younger population. Methods: Clinical registry data for elderly patients (>60 years) were compared with those <60 years from a cohort of 85 adults with focal onset epilepsy who have received perampanel since 09/2012. Treatment response and AEs are reported according to age group, while controlling for perampanel dose and concomitant anti-epileptic drugs (AEDs). Results: Twenty elderly patients (7 female; mean age 69.8 years, SD 11.5) and 65 younger patients (39 female; mean age 36.8 years; SD 11.5) were included. Over 57 months, 75% (15/20) elderly patients and 53.8% [35/65] younger patients were still taking perampanel, and 35% (7/20) elderly patients were seizure free compared with 13.8% (9/65) younger patients (p=0.009). In the elderly group, 5% (1/20) experienced seizure reduction 50-75%, and 20% (4/20) experienced seizure reduction <50% (versus 3.1% [2/65] seizure reduction >75%; 15.4% [10/65] seizure reduction 50-75%; and 56.9% [37/65] seizure reduction <50% in younger patients). Thirty-five percent (7/20) of elderly patients experienced AEs compared with 55.4% (36/65) younger patients (p=0.563). Speech effects (30%) and fatigue (20%) were the most common adverse effects in the elderly group, while vertigo (40%) and psychiatric effects (9.2%) were most common in younger patients. Conclusions: Perampanel efficacy and tolerability in the elderly population mirrors that seen in younger patients. These real-life data suggest a broad patient base for whom perampanel may be a useful add-on treatment, potentially leading to improved safety, independence and quality of life in elderly patients.