View in EDS HTML Full Text PDF Full Text

Perampanel for focal epilepsy: insights from early clinical experience.

Saved in:
Bibliographic Details
Title: Perampanel for focal epilepsy: insights from early clinical experience.
Authors: Trinka, E., Steinhoff, B. J., Nikanorova, M., Brodie, M. J.
Source: Acta Neurologica Scandinavica. Mar2016, Vol. 133 Issue 3, p160-172. 13p.
Subjects: Treatment of epilepsy, Nasopharyngitis, Drowsiness, Adjunctive behavior, Adverse health care events, Clinical trials
Abstract: Perampanel is approved for adjunctive therapy of focal epilepsy with or without secondarily generalized seizures in patients aged >12 years. This narrative review uses real-world and clinical trial data to elucidate perampanel's role in the clinic. Audit data show good tolerability with perampanel and higher freedom-from-seizure rates in elderly vs younger patients. When using perampanel in elderly patients, special attention should be given to comorbidities and co-medication to avoid potential interactions or adverse events. Slower titration is generally recommended, and seizure control should be reassessed at a dose of 4 mg before further dose increases. Perampanel efficacy is similar in adolescents and adults; however, somnolence, nasopharyngitis, and aggression are more frequent in adolescents vs the overall population. Individualized and slow-dose titration can minimize adverse events. Low serum concentrations of perampanel may occur in patients also receiving some enzyme-inducing anti-epileptic drugs; a perampanel dose increase may be required. Adverse events of importance with perampanel include dizziness; anger, aggression, and hostile behavior (particularly in adolescents); and falls (particularly in patients >65 years). An individualized approach to dosing, including slower up-titration and bedtime dosing, reduces dizziness risk. Other drugs may cause or aggravate dizziness; reducing concomitant drugs may be necessary when up-titrating perampanel. It would seem clinically appropriate to give due consideration to avoiding use in patients with a history of anger or hostile/aggressive behavior. The possibility of such behaviors should be discussed with patients before starting perampanel, with monitoring during up-titration. Slower up-titration of perampanel in older patients helps reduce fall risk. [ABSTRACT FROM AUTHOR]
Copyright of Acta Neurologica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
Full text is not displayed to guests.
FullText Links:
  – Type: pdflink
Text:
  Availability: 1
Header DbId: pbh
DbLabel: Psychology and Behavioral Sciences Collection
An: 112333787
AccessLevel: 6
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: Perampanel for focal epilepsy: insights from early clinical experience.
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Trinka%2C+E%2E%22">Trinka, E.</searchLink><br /><searchLink fieldCode="AR" term="%22Steinhoff%2C+B%2E+J%2E%22">Steinhoff, B. J.</searchLink><br /><searchLink fieldCode="AR" term="%22Nikanorova%2C+M%2E%22">Nikanorova, M.</searchLink><br /><searchLink fieldCode="AR" term="%22Brodie%2C+M%2E+J%2E%22">Brodie, M. J.</searchLink>
– Name: TitleSource
  Label: Source
  Group: Src
  Data: <searchLink fieldCode="JN" term="%22Acta+Neurologica+Scandinavica%22">Acta Neurologica Scandinavica</searchLink>. Mar2016, Vol. 133 Issue 3, p160-172. 13p.
– Name: Subject
  Label: Subjects
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Treatment+of+epilepsy%22">Treatment of epilepsy</searchLink><br /><searchLink fieldCode="DE" term="%22Nasopharyngitis%22">Nasopharyngitis</searchLink><br /><searchLink fieldCode="DE" term="%22Drowsiness%22">Drowsiness</searchLink><br /><searchLink fieldCode="DE" term="%22Adjunctive+behavior%22">Adjunctive behavior</searchLink><br /><searchLink fieldCode="DE" term="%22Adverse+health+care+events%22">Adverse health care events</searchLink><br /><searchLink fieldCode="DE" term="%22Clinical+trials%22">Clinical trials</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Perampanel is approved for adjunctive therapy of focal epilepsy with or without secondarily generalized seizures in patients aged >12 years. This narrative review uses real-world and clinical trial data to elucidate perampanel's role in the clinic. Audit data show good tolerability with perampanel and higher freedom-from-seizure rates in elderly vs younger patients. When using perampanel in elderly patients, special attention should be given to comorbidities and co-medication to avoid potential interactions or adverse events. Slower titration is generally recommended, and seizure control should be reassessed at a dose of 4 mg before further dose increases. Perampanel efficacy is similar in adolescents and adults; however, somnolence, nasopharyngitis, and aggression are more frequent in adolescents vs the overall population. Individualized and slow-dose titration can minimize adverse events. Low serum concentrations of perampanel may occur in patients also receiving some enzyme-inducing anti-epileptic drugs; a perampanel dose increase may be required. Adverse events of importance with perampanel include dizziness; anger, aggression, and hostile behavior (particularly in adolescents); and falls (particularly in patients >65 years). An individualized approach to dosing, including slower up-titration and bedtime dosing, reduces dizziness risk. Other drugs may cause or aggravate dizziness; reducing concomitant drugs may be necessary when up-titrating perampanel. It would seem clinically appropriate to give due consideration to avoiding use in patients with a history of anger or hostile/aggressive behavior. The possibility of such behaviors should be discussed with patients before starting perampanel, with monitoring during up-titration. Slower up-titration of perampanel in older patients helps reduce fall risk. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Acta Neurologica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=112333787
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1111/ane.12529
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 13
        StartPage: 160
    Subjects:
      – SubjectFull: Treatment of epilepsy
        Type: general
      – SubjectFull: Nasopharyngitis
        Type: general
      – SubjectFull: Drowsiness
        Type: general
      – SubjectFull: Adjunctive behavior
        Type: general
      – SubjectFull: Adverse health care events
        Type: general
      – SubjectFull: Clinical trials
        Type: general
    Titles:
      – TitleFull: Perampanel for focal epilepsy: insights from early clinical experience.
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Trinka, E.
      – PersonEntity:
          Name:
            NameFull: Steinhoff, B. J.
      – PersonEntity:
          Name:
            NameFull: Nikanorova, M.
      – PersonEntity:
          Name:
            NameFull: Brodie, M. J.
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 03
              Text: Mar2016
              Type: published
              Y: 2016
          Identifiers:
            – Type: issn-print
              Value: 00016314
          Numbering:
            – Type: volume
              Value: 133
            – Type: issue
              Value: 3
          Titles:
            – TitleFull: Acta Neurologica Scandinavica
              Type: main
ResultId 1