Perampanel for idiopathic generalized epilepsy passes muster in real world

Perampanel appears to be effective and have good tolerability in patients with idiopathic generalized epilepsy treated in everyday clinical practice settings, as shown in a study.

For the study, researchers performed a subgroup analysis of the retrospective PERMIT study, in which perampanel was evaluated in patients with focal and generalized epilepsy treated under real-world conditions across 17 countries.

The full analysis set included 544 patients with idiopathic generalized epilepsy (mean age 33.3 years, 51.9 percent women, mean epilepsy duration 18.1 years).

Retention and effectiveness measurements were assessed at 3, 6, and 12 months. Effectiveness was examined by seizure type (total seizures, generalized tonic-clonic seizures [GTCS], myoclonic seizures, absence seizures) and defined as ≥50-percent responder rate and seizure freedom rate (no seizures since at least the previous visit). Meanwhile, safety/tolerability was monitored throughout perampanel treatment and assessed by recording the frequency of adverse events (AEs), including psychiatric AEs and those leading to treatment discontinuation.

The proportion of patients who were retained on perampanel treatment (retention population, n=497) was 92.4 percent at 3 months, 85.5 percent at 6 months, and 77.3 percent at 12 months. At the last visit (effectiveness population, n=467), responder and seizure freedom rates were 74.2 percent and 54.6 percent for total seizures, 81.2 percent and 61.5 percent for GTCS, 85.7 percent and 66.0 percent for myoclonic seizures, and 90.5 percent and 81.0 percent for absence of seizures, respectively.

In terms of safety (tolerability population, n=520), AEs were documented in 42.9 percent of patients. AEs included irritability (9.6 percent), dizziness/vertigo (9.2 percent), and somnolence (6.3 percent). AEs led to treatment discontinuation in 12.4 percent of patients over 12 months.

The present data are consistent with clinical trial evidence and support perampanel as a broad-spectrum antiseizure medication for the treatment of idiopathic generalized epilepsy.