Francesco Brigo1, Simona Lattanzi2, Alexandra Rohracher3, Emilio Russo4, Stefano Meletti5, Elisabetta Grillo6, Eugen Trinka7. 1. Neuroscience, Biomedicine and Movement Sciences, University of Verona, Italy; Department of Neurology, Franz Tappeiner Hospital, Merano, Italy. Electronic address: dr.francescobrigo@gmail.com. 2. Neurological Clinic, Marche Polytechnic University, Ancona, Italy. 3. Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria. 4. Department of Science of Health, University Magna Graecia of Catanzaro, Catanzaro, Italy. 5. Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy. 6. Medical Department Eisai s.r.l., San Donato Milanese, Italy. 7. Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria; Center for Cognitive Neuroscience, Salzburg, Austria; Public Health, Health Services Research and HTA, University for Health Sciences, Medical Informatics and Technology, Hall i.T., Austria.
Abstract
OBJECTIVE: Perampanel (PER) is a noncompetitive β-amino-3-(5-methyl-3-oxo-1,2-oxazol-4-yl)propionic acid (AMPA) receptor antagonist with demonstrated efficacy in animal models of status epilepticus (SE). We performed a systematic review of the literature to assess the efficacy and tolerability of PER in the treatment of refractory and super-refractory SE. METHODS: We searched Medline, Embase, and CENTRAL (accessed from inception to April 30, 2018) to identify studies evaluating oral PER as treatment of SE of any type. We also searched the OpenGrey repository and conference proceedings of international congresses by the International League Against Epilepsy and by the American Epilepsy Society from 2012 onwards. RESULTS: Ten articles were included, with a total of 69 episodes of SE occurring in 68 patients (aged 18 to 91 years). The type and etiology of SE varied remarkably across studies. The number of drugs used prior to PER ranged from 1 to 9. The time from SE onset to PER administration ranged from 9.25 h to 35 days. The initial PER dose ranged from 2 to 32 mg. The proportion of patients achieving clinical SE cessation varied from 17% to 100%. The time from PER administration to SE cessation ranged from 1 h to 4 weeks. CONCLUSIONS: The currently available evidence supporting the use of PER in SE is weak and hampered by several confounding factors. Further studies should be performed in more clinically homogeneous and larger cohorts to evaluate the efficacy and safety of PER administered in earlier stages of SE, at higher dosages, and at intervals shorter than 24 h.
OBJECTIVE:Perampanel (PER) is a noncompetitive β-amino-3-(5-methyl-3-oxo-1,2-oxazol-4-yl)propionic acid (AMPA) receptor antagonist with demonstrated efficacy in animal models of status epilepticus (SE). We performed a systematic review of the literature to assess the efficacy and tolerability of PER in the treatment of refractory and super-refractory SE. METHODS: We searched Medline, Embase, and CENTRAL (accessed from inception to April 30, 2018) to identify studies evaluating oral PER as treatment of SE of any type. We also searched the OpenGrey repository and conference proceedings of international congresses by the International League Against Epilepsy and by the American Epilepsy Society from 2012 onwards. RESULTS: Ten articles were included, with a total of 69 episodes of SE occurring in 68 patients (aged 18 to 91 years). The type and etiology of SE varied remarkably across studies. The number of drugs used prior to PER ranged from 1 to 9. The time from SE onset to PER administration ranged from 9.25 h to 35 days. The initial PER dose ranged from 2 to 32 mg. The proportion of patients achieving clinical SE cessation varied from 17% to 100%. The time from PER administration to SE cessation ranged from 1 h to 4 weeks. CONCLUSIONS: The currently available evidence supporting the use of PER in SE is weak and hampered by several confounding factors. Further studies should be performed in more clinically homogeneous and larger cohorts to evaluate the efficacy and safety of PER administered in earlier stages of SE, at higher dosages, and at intervals shorter than 24 h.
Authors: Richard J Burman; Richard E Rosch; Jo M Wilmshurst; Arjune Sen; Georgia Ramantani; Colin J Akerman; Joseph V Raimondo Journal: Nat Rev Neurol Date: 2022-05-10 Impact factor: 44.711
Authors: Laurent M Willems; Sebastian Bauer; Kolja Jahnke; Martin Voss; Felix Rosenow; Adam Strzelczyk Journal: CNS Drugs Date: 2020-08 Impact factor: 5.749
Authors: Ashish Dhir; Donald A Bruun; Michelle Guignet; Yi-Hua Tsai; Eduardo González; Jonas Calsbeek; Joan Vu; Naomi Saito; Daniel J Tancredi; Danielle J Harvey; Pamela J Lein; Michael A Rogawski Journal: Ann N Y Acad Sci Date: 2020-09-11 Impact factor: 5.691
Authors: Juan G Ochoa; Michelle Dougherty; Alex Papanastassiou; Barry Gidal; Ismail Mohamed; David G Vossler Journal: Epilepsy Curr Date: 2021-03-10 Impact factor: 7.500