A Prospective, Longitudinal Study Of Ampa-Antagonist In Chinese Patients With Refractory Epilepsy
Refereed conference paper presented and published in conference proceedings

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AbstractPurpose : Perampanel is an AMPA- antagonist that is noncompetitive for the AMPA receptors. This new mechanism
of drug offers new opportunities for patients with refractory epilepsy.
Method : Adult patients(aged > 18) were recruited for the purpose of longitudinal study with a diagnosis of refractory epilepsy. An 8- week titration phase was followed by an 8- week maintenance phase. The patient was evaluated at baseline and at the end of the 16- week period with clinical history and examination, blood tests and Neuropsychiatric Inventory(NPI) and the Zarit- Burden Interview(ZBI). Thereafter, the patient entered into the observation period with variable follow- up periods. The primary end- points were the 50% responder- rate and seizure reduction. The secondary end- points were the scores registered on NPI and ZBI.
Results : A total of 51 patients were prospectively recruited for the study. The mean age was 40.9(21–64,SD = 12.3). Female patients constituted 64.7%. There were 10 early withdrawals from study before the completion of the 16- week period. The intention- to- treat analysis showed that the 50% responderrate was 45%(23/51) in the titration phase and 49%(25/51) for the maintenance phase. The proportion of patients achieving seizure freedom was 9.9%(5/51) and 15.7%(8/51) respectively. The mean changes in seizure frequency were - 246% and - 284% respectively. Treatment- emergent- adverseeffects (TEAE) were recorded in 56.9%(29/51) of patients. The most common TEAE was drowsiness/ sleepiness/ tiredness(11/51, 21.6%), dizziness(4/51, 7.8%), behavioural problem(4/51, 7.8%) and weight gain(4/51, 7.8%). The mean dosage of perampanel was 3 mg/d in the maintenance- phase. The mean score of pre- treatment- NPI was 13.45(SD = 12.10), which was higher than that of the post- treatment- NPI(mean score12.33(SD = 10.70)(p < 0.001)).
A similar pattern was found for ZBI(p = 0.009). A subgroup analysis of patients with encephalitis showed a high proportion of seizure freedom in maintenance- phase(25%,p = 0.59).
Conclusions : Perampanel as an adjunctive therapy for epilepsy is clinically efficacious and well tolerated. A subgroup analysis for patients with encephalitis suggested promising results - for those who responded, the proportion achieving seizure freedom was significantly higher.
All Author(s) ListLeung H, Yuen SL, Ma K, Ip B, Ma SH, Leung T, Yip KL, Mok V
Name of Conference33rd International Epilepsy Congress
Start Date of Conference22/06/2019
End Date of Conference26/06/2019
Place of ConferenceBangkok
Country/Region of ConferenceThailand
Proceedings TitleEPILEPSIA
Title of PublicationEPILEPSIA
Volume Number60
Issue NumberSuppl. 2
Article numberP267
Pages127 - 128
LanguagesEnglish-United Kingdom
Web of Science Subject CategoriesClinical Neurology;Neurosciences & Neurology

Last updated on 2021-13-05 at 01:31