Efficacy and safety of Perampanel in the treatment of post stroke epilepsy: A multicenter, real-world study
Cuihua Yan,
Tingting Yang,
Yuanping Sun,
Junji Hu,
Xiangming Yi,
Chunxiao Li,
Juan Chen,
Kunkun Wei,
Jing Jiang,
Qi Xiang,
Anru Liu,
Yuxiang Han,
Liling Yang,
Xiaoyun Liu,
Tao Han,
Xuewu Liu
Affiliations
Cuihua Yan
Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, PR China; Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, PR China; Institute of Epilepsy, Shandong University, Jinan, Shandong, PR China
Tingting Yang
Institute of Epilepsy, Shandong University, Jinan, Shandong, PR China; Department of Neurology, Qilu Hospital of Shandong University, Jinan, Shandong, PR China
Yuanping Sun
Qingdao University Affiliated Hospital, Qingdao, Shandong, PR China
Junji Hu
Department of Neurology, Zibo Changguo Hospital, Zibo, Shandong, PR China
Xiangming Yi
Binzhou Medical College Affiliated Hospital, Binzhou, Shandong, PR China
Chunxiao Li
Qingdao University Affiliated Hospital, Qingdao, Shandong, PR China
Juan Chen
The Third People's Hospital of Heze City, Heze, Shandong, PR China
Kunkun Wei
Qingdao Women and Children's Hospital, Qingdao, Shandong, PR China
Jing Jiang
Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, PR China; Institute of Epilepsy, Shandong University, Jinan, Shandong, PR China
Qi Xiang
Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, PR China; Institute of Epilepsy, Shandong University, Jinan, Shandong, PR China
Anru Liu
Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, PR China; Institute of Epilepsy, Shandong University, Jinan, Shandong, PR China
Yuxiang Han
Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, PR China
Liling Yang
Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, PR China
Xiaoyun Liu
Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, PR China
Tao Han
Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, PR China; Institute of Epilepsy, Shandong University, Jinan, Shandong, PR China; Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, PR China; Corresponding author. Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, PR China.
Xuewu Liu
Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, PR China; Institute of Epilepsy, Shandong University, Jinan, Shandong, PR China; Corresponding author. Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, PR China.
Background: Since 2019, Perampanel (PER) has been endorsed in China as an adjunctive treatment for focal seizures, both with and without impaired awareness, and for the transition from focal to bilateral tonic-clonic seizures. Limited research exists regarding the efficacy of PER in treating post-stroke epilepsy (PSE) in China. Empirical studies are essential to guide treatment protocols. We conducted a retrospective study to assess the efficacy and tolerability of PER in 58 PSE patients treated between October 2019 and July 2023. Method: This study encompassed 58 patients with PSE, treated with PER either as monotherapy or as part of adjunctive therapy, and underwent follow-up for a minimum duration of 6 months. The study assessed changes in seizure frequency, adverse events (AEs), drug retention rate, maintenance dose, and adverse reactions following PER treatment. Results: The study included 58 PSE patients, with 60.3% males and 39.7% females, ranging in age from 18 to 89, mostly within the 61–70 age group. Ischemic strokes constituted 58.6% of cases, while hemorrhagic strokes accounted for 41.4%. Focal seizures, either with or without impaired awareness, were noted in 62.1% of patients, and a transition from focal to bilateral tonic-clonic seizures was seen in 32.8%. The retention rates for PER at 3 and 6 months stood at 94.8% and 84.5% respectively, and the most commonly administered maintenance dose was 4 mg/day (41.28%). In the adjunctive therapy group, efficacy rates were 66.7% at 3 months and 78.6% at 6 months, compared to 80.0% at 3 months and 85.7% at 6 months in the monotherapy group. In the efficacy analysis, with a criterion of ≥50% reduction in seizure frequency, the overall efficacy rates at 3 and 6 months were 69.1% and 79.6%, respectively. Adverse reactions occurred in 46.6% of patients, primarily involving irritability and somnolence (both 27.6%), with no marked difference in incidence between the adjunctive and monotherapy groups (P > 0.05). Conclusion: PER exhibits favorable efficacy and tolerability in Chinese PSE patients, possibly at lower doses.
