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Perampanel significantly effective in reducing seizures in Lennox-Gastaut syndrome
Italy: Researchers have provided real-world evidence on perampanel (PER) effectiveness in managing Lennox-Gastaut syndrome (LGS) seizures. This study was published in Epilepsia. The lead researcher of this study is Sara Matricardi.
Lennox–Gastaut syndrome (LGS) is a developmental and epileptic encephalopathy (DEE) with onset between 18 months and eight years. The condition has a poor response to pharmacological and nonpharmacological therapies.
There needs to be more data and evidence on treatment. Valproate remains a primary therapeutic option. This study aimed to assess the long-term effectiveness of PER as an adjunctive treatment of seizures in a cohort of children and adults with LGS.
Time to PER failures (discontinuation/initiation of other treatment) and time to seizure relapse (seizure occurrence in seizure-free patients and increase of 50 % in average frequency of seizures) in responders were the primary outcomes measured in the study.
The study summary includes the following:
- Researchers included Eighty-seven patients.
- Fifty-two subjects had treatment failure constituting 59.8% of subjects at a median of 12 months.
- Twenty-seven patients had a lack of efficacy, 14 had a lack of tolerability, and 11 had both reasons. This was the cause of Treatment failure constituting 52%, 27 % and 21 %, respectively.
- A slower titration lowered the risk of PER failure than faster titration schedules.
- There was an association between adverse events and an increased risk of treatment failure.
- Thirty-six patients were responders in a follow-up of 11 months.
- Seizure relapse occurred in 36.1% of patients after 21 months (median time).
- At the end of the follow-up, the overall rate of seizure responders was 26.4%.
- This study provides real-world evidence of the effectiveness of PER as adjunctive treatment in LGS patients.
The study strengths were recruitment at multiple sites, real-world design, treatment outcomes measured and increased generalizability of the results. Major limitations include open-label and retrospective design, lack of control group, and sources of bias.
Concluding further, PER is effective in LGS patients. It is well tolerated, and there is a possible partial loss of efficacy in a few patients over time.
They said, based on the findings of our study, PER is a valuable therapeutic option for LGS patients with inadequately controlled seizures.
They also mentioned that “we cannot draw firm conclusions on its usage as a first-line treatment.”
More information is required on the underlying pathophysiological mechanisms of LGS for a better-personalised approach and to develop disease-modifying treatments.
Further reading:
Long-term effectiveness of add-on perampanel in patients with Lennox–Gastaut syndrome: A multicenter retrospective study.
BDS, MDS in Periodontics and Implantology
Dr. Aditi Yadav is a BDS, MDS in Periodontics and Implantology. She has a clinical experience of 5 years as a laser dental surgeon. She also has a Diploma in clinical research and pharmacovigilance and is a Certified data scientist. She is currently working as a content developer in e-health services. Dr. Yadav has a keen interest in Medical Journalism and is actively involved in Medical Research writing.
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751