Abstracts

Rationale: Perampanel constitutes a new antiepileptic drug with a novel mechanism acting as a non-competitive antagonist of AMPA receptors of glutamate. It has been approved for the treatment of focal seizures with or without secondary generalization (SGS) and primary generalized tonic-clonic seizures. Methods: Multicentric observational one year study of patients with focal epilepsy treated with perampanel as early add-on according to daily clinical practice performed in Galicia, Spain, with participation of six second-and-third level of assistance centers. Data at 3, 6 and 12 months was recorded. Patients had previously received a maximum of 2 AEDs and take 1-2 FAEs as concomitant treatment. Efficacy, adherence, safety and tolerability are analyzed. Results: N=77 patients were included. N=64 and N=47 reached 6 and 12 months of follow-up respectively. N=44 (57.14%) were males. Median age was 46 [33, 58] years old and median time of evolution of epilepsy was 9 [5, 24] years. Median dose of perampanel at 3, 6 and 12 months was 4 [4, 4], 4 [4, 6] and 6 [4, 8] mg/day. After 3 months, N=17 patients (25.75%) were seizure free, with > 50% efficacy in N=43 (65.15%). At 6 months, N=42 were responders (67.74%), with N=28 of them (43.75%) free of seizures. After 12 months, N=27 were responders (57.44%) including 25.53% (N=12) seizure-free. N=25 patients reported adverse events after 3 months with N=5 of them leading to withdrawal (only N=1 was considered severe: irritability). N=16 and N=11 patients reported adverse events after 6 and 12 months (none severe). The most frequent were somnolence followed by irritability. N=25 patients suffered from SGS. N=20 reached 3 months of follow-up and N=14 (70%) were free of these type of seizures. N=19 were followed for 6 months: N=14 (73.68%) were SGS-free and N=13 reached 12 months of follow up, with 76.92% free of SGS (N=10). Conclusions: Perampanel has showed efficacy in focal epilepsies as early add-on treatment, with very good results in secondary generalized tonic-clonic seizures. Its high adherence together and adeccuate tolerability, considering also its novel mechanism of action, makes perampanel an atractive option as early add-on for the treatment of focal epilepsies. Longer follow-up is needed to certify these preliminary results. Funding: None funding was recieved in support of this abstract.