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Adverse Events During Perampanel Adjunctive Therapy in Intractable Epilepsy

Authors
 Song Ee Youn  ;  Se Hee Kim  ;  Ara Ko  ;  Sun Ho Lee  ;  Young Mock Lee  ;  Hoon Chul Kang  ;  Joon Soo Lee  ;  Heung Dong Kim 
Citation
 Journal of Clinical Neurology, Vol.14(3) : 296-302, 2018 
Journal Title
 Journal of Clinical Neurology 
ISSN
 1738-6586 
Issue Date
2018
Keywords
antiepileptic drug ; drug-resistant epilepsy ; perampanel ; alpha-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid
Abstract
BACKGROUND AND PURPOSE: Perampanel is the first alpha-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid (AMPA)-receptor antagonist developed to treat epilepsy. The effects of either rapid or slow dose titration on adverse events remain to be elucidated. METHODS: Eighty-five patients received perampanel between March 2016 and August 2016. Patients were divided into two groups according to their dosing schedule: rapid dose titration (2-mg increments at intervals of 1 to 2 weeks) and slow dose titration (2-mg increments at intervals of at least 3 weeks). Seizure frequency and adverse events were analyzed over 3 months. RESULTS: Adverse events were reported by 47 (58%) of the 81 patients analyzed, with 12 (15%) patients discontinuing perampanel due to adverse events. Common adverse events included dizziness (n=30, 37%), aggressive mood and behavior (n=19, 24%), gait disturbance (n=16, 20%), and sleep problems (n=10, 12.4%). The overall adverse events were similar in the slow-titration group (38 of 61 patients) and the rapid-titration group (8 of 20 patients, p=0.081). However, none of the 20 patients in the slow-titration group experienced gait disturbance, compared with 16 of the 61 patients in the rapid-titration group (p=0.009), while appetite change was experienced by 4 patients in the slow-titration group but only 1 in the rapid-titration group (p=0.003). No relationship was noted between adverse events and the maximum dose of perampanel (p=0.116). Sex differences were observed, with the response to perampanel being better and the rate of adverse events being higher in females (p=0.015 and p=0.046, respectively). CONCLUSIONS: Slow titration of perampanel may reduce perampanel-related adverse events.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/162623
Files in This Item:
T201801989.pdf Download
DOI
10.3988/jcn.2018.14.3.296
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실)
Yonsei Authors
강훈철(Kang, Hoon Chul) ORCID logo https://orcid.org/0000-0002-3659-8847
고아라(Ko, A Ra)
김세희(Kim, Se Hee) ORCID logo https://orcid.org/0000-0001-7773-1942
김흥동(Kim, Heung Dong)
윤송이(Youn, Song Ee)
이선호(Lee, Sun Ho)
이영목(Lee, Young Mock) ORCID logo https://orcid.org/0000-0002-5838-249X
이준수(Lee, Joon Soo)
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