Efficacy and tolerability of adjunctive perampanel treatment in children under 12 years of age with refractory epilepsy.

Efficacy and tolerability of adjunctive perampanel treatment in children under 12 years of age with refractory epilepsy.

Korean J Pediatr. 2018 Dec 26;:

Authors: Yun Y, Kim D, Lee YJ, Kwon S, Hwang SK

Abstract
Purpose: There is limited data on the use of perampanel in children under 12 years of age. We evaluated the efficacy and tolerability of adjunctive perampanel treatment in children under 12 years of age with refractory epilepsy.
Methods: This retrospective observational study was performed in Kyungpook National University Hospital from July 2016 to March 2018. Responder was defined as a patient with ≥50% reduction in monthly seizure frequency compared with the baseline. Adverse events and discontinuation data were obtained to evaluate tolerability.
Results: A total of 22 patients (8 male, 14 female) aged 3.1 to 11.4 years (mean 8.0±2.5 years) were included in this study. After an average of 9.2 months (range 0.5-19) of follow-up, 15 patients (68%) showed response in seizure frequency reduction including 5 patients (23%) with seizure freedom. Age at epilepsy onset was significantly younger (P=0.048); duration of epilepsy was significantly longer (P=0.019) in responders than in non-responders. Nine patients (41%) experienced adverse events including somnolence (23%), respiratory depression (9%), violence (4.5%), and seizure aggravation (4.5%). The most serious adverse event was respiratory depression which required mechanical ventilation in 2 patients (9%). Eight patients (36%) discontinued perampanel due to lack of efficacy or adverse events. Three out of four patients (75%) who discontinued perampanel due to adverse events had an underlying medical condition.
Conclusion: Perampanel offers a treatment option for refractory epilepsy in children as in adults. Adjunctive treatment with perampanel requires special consideration in those with underlying medical conditions to prevent serious adverse events.

PMID: 30590000 [PubMed - as supplied by publisher]

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