Impact of Perampanel for First-Episode Seizures versus Usual Care on Clinical Outcome and Safety Profile Aspects of the Thai Experience.

BACKGROUND AND PURPOSE: Epilepsy increases poor outcomes in patients with post-traumatic brain injury and brain tumor-related epilepsy, for whom early seizure control is essential. Perampanel (PER) was a known third-generation antiepileptic drug for treatment all types of seizures. The objective of the study is to compare clinical outcomes and safety of PER administration as monotherapy.

METHODS

A prospective study of all 84 patients assigned to PER monotherapy (PER group, n=36) and other first-line antiepileptic drugs (n=48). Clinical outcomes parameters were measured by the prevalence of patients with a diminish in seizure frequency at 50% in 28 days. From November 1, 2020 to April 30, 2024, comparing the PER group with usual care. Clinical outcomes included adherence rate and seizure-free proportion at 28 days and 6 months. Adverse drug reactions were recorded in both groups.

RESULTS

There was no difference in demographic data and incidence of adverse drug reactions between two groups. Median PER dosage was 4 mg (range, 2-12 mg). Compared to other antiepileptic drugs, the PER group had a prevalence of 50% responder rate at 28 days and 6 months significantly were 75%, 81%, 65%, and 51% respectively. Common adverse drug reactions were somnolence and dizziness.

CONCLUSIONS

PER administration as monotherapy demonstrated good efficacy and less adverse drug reactions. Low dosages helped to decrease adverse drug reactions and improved retention rate.