ANA Annual Meeting

ANA Annual Meeting

Source:

Marawar R, et al. Poster 347. Presented at: American Neurological Association Annual Meeting; Oct. 17-19, 2021 (virtual meeting).

Disclosures: Marawar reports receiving grant support from Eisai Medicines. Please see the study for all other authors’ relevant financial disclosures.
October 19, 2021
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Adjunctive perampanel effective in older patients with focal-onset seizures

Source:

Marawar R, et al. Poster 347. Presented at: American Neurological Association Annual Meeting; Oct. 17-19, 2021 (virtual meeting).

Disclosures: Marawar reports receiving grant support from Eisai Medicines. Please see the study for all other authors’ relevant financial disclosures.
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Long-term adjunctive perampanel treatment was efficacious and generally well tolerated among older patients with focal-onset seizures, according to findings presented at the annual meeting of the American Neurological Association.

Rohit Marawar

“Elderly patients represent the most rapidly growing cohort of the epilepsy population,” Rohit Marawar, MD, assistant professor in the department of neurology and program director of the Adult Epilepsy Fellowship Training Program at Wayne State University in Michigan, said during a virtual presentation. “However, there is limited information on the efficacy and safety of antiseizure medications in this patient population.”

According to the study abstract, perampanel is a once-daily, oral antiseizure medication for focal-onset seizures and generalized tonic-clonic seizures (GTCS). It is approved as monotherapy and adjunctive therapy for focal-onset seizures, with or without focal to bilateral tonic-clonic seizures (FBTCS), among individuals aged 4 years or older and as adjunctive therapy for GTCS among patients aged 12 years or older.

Pharmacokinetic analyses showed that enzyme-inducing antiseizure medications (EIASMs) increased perampanel clearance, meaning patients receiving concomitant EIASMs may need a higher perampanel dose to reach similar efficacy as patients receiving non-EIASMs.

In the current post-hoc analysis, Marawar and colleagues used data from two studies to assess the long-term safety and efficacy of perampanel among patients aged 60 years or older with focal-onset seizures in the presence and absence of EIASMs.

Pooled safety analysis set data were available for 70 patients aged 60 years or older with focal-onset seizures. A total of 59.2% of these patients had a history of FBTCS.

Results showed improvements in seizure control among patients who received adjunctive perampanel regardless of concomitant EIASM use. The researchers noted higher seizure reductions across years 2, 3 and 4 among patients who received concomitant EIASMs vs. those who received non-EIAMs; however, the small numbers of eligible results may limit interpretation of these results, according to the study abstract.

Patients who received EIASMs had similar rates of treatment-emergent adverse events as those who received non-EIASMs during years 1, 2 and 3, yet numbers were too small to meaningfully compare the subgroups during year 4, Marawar and colleagues noted.

“These data suggest that perampanel may provide an effective treatment option in elderly patients with focal-onset seizures using concomitant EIASMs and is generally well tolerated in this patient population,” Marawar said during the presentation. “However, higher perampanel doses may be required to achieve seizure control in patients receiving concomitant EIASMs compared with those receiving only non-EIASMs.”