Perampanel, a novel antiepileptic drug, was associated with a reduction in seizure frequency of at least 50% in more than half of children and adolescents in a meta-analysis.
Perampanel was shown to be well tolerated and effective in the treatment of children and adolescents with epilepsy, according to study findings published in Brain and Development.
Characterized by researchers as the first noncompetitive α-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid (AMPA) receptor antagonist to receive regulatory approval, perampanel is currently approved in several countries for the treatment of partial epileptic seizure and primary generalized tonic-clonic epilepsy in patients 12 years and older.
“However, due to the relatively short marketing time, the efficacy, safety, and tolerability of [perampanel] in various types of epilepsy are not completely clear, and the dosage of perampanel in children and adolescents is still under exploration,” the authors noted. “There are several antiseizure drugs, involving more than 30 different molecular targets, but still, about a third of patients develop drug-resistant epilepsy.”
With epilepsy beginning in most patients during childhood and adolescence, the study authors conducted a systematic review and meta-analysis to further investigate the optimal dosage, efficacy, tolerability, and safety of perampanel in pediatric patients with various types of disease.
Data on patients younger than 20 years with epilepsy of any type treated with perampanel as monotherapy or add-on therapy, which were derived from clinical studies registered in the PubMed, Embase, and Cochrane Library databases up to November 2022, were eligible for inclusion.
For the analysis, the primary efficacy outcome was the number of patients with complete cessation of seizures, with the secondary outcome being the number of patients with at least a 50% reduction in the number of seizures compared with baseline. Other efficacy end points included the initial and maintenance doses of perampanel, the dose of perampanel in patients with favorable responses, and the patient’s previous use of other antiseizure drugs.
Safety was measured via adverse reactions, which included the incidence and severity of various types of adverse reactions and the incidence of withdrawal from the experiment due to adverse reactions of perampanel.
A total of 21 studies involving 1968 children and adolescent patients were included in the meta-analysis, of which one randomized controlled trial (RCT), 3 cohort studies, 16 case series studies, and 1 cross-sectional study were cited.
Findings demonstrated significant efficacy of perampanel among children and adolescents, with the drug reported to be generally well tolerated as well:
Researchers acknowledged that as only 1 RCT study was included in the meta-analysis, and the other 13 studies had no control group and most of them were retrospective studies, findings may have lower reliability. The lack of included literature was also cited as a limitation of the study findings as they could not examine the effect of perampanel on each type of epilepsy separately.
“The use of perampanel in children and adolescents with epilepsy can significantly reduce the frequency of seizures, and it is well tolerated. It can be used as an add-on or second-line treatment for children and adolescents with epilepsy who are poorly controlled by other anti-seizure drugs,” the study authors concluded. “Large-scale randomized controlled trials are needed to continue to explore the efficacy and safety of perampanel.”
Reference
Sun S, Li X, Liu X. Efficacy, tolerability and safety of perampanel in children and adolescents with epilepsy: dystematic review and meta-analysis. Brain Dev. Published online March 4, 2023. doi:10.1016/j.braindev.2023.02.007
Public Hospitals More Likely to Extend Unprofitable Services After 340B Participation, Study Finds
May 10th 2024Public hospitals were significantly more likely to sustain access to unprofitable services following 340B Drug Pricing Program participation, while nonprofit hospitals were mostly unaffected, according to a recent study.
Read More
Frameworks for Advancing Health Equity: Urban Health Outreach
May 9th 2024In the series debut episode of "Frameworks for Advancing Health Equity," Mary Sligh, CRNP, and Chelsea Chappars, of Allegheny Health Network, explain how the Urban Health Outreach program aims to improve health equity for individuals experiencing homelessness.
Listen
Research Shows Prior Authorization Denials Delay Critical Immunology Care
May 10th 2024Results featured at the Academy of Managed Care Pharmacy 2024 annual meeting revealed a pattern of prior authorization rejections that could delay necessary therapeutic treatments for various patient groups.
Read More
Examining Low-Value Cancer Care Trends Amidst the COVID-19 Pandemic
April 25th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the April 2024 issue of The American Journal of Managed Care® about their findings on the rates of low-value cancer care services throughout the COVID-19 pandemic.
Listen
Patients With Advanced, Recurrent Melanoma May Experience Lasting AEs From ICM Therapy
May 9th 2024A cross-sectional, mixed-methods study found that adverse effects (AEs) can occur even after 1 year of treatment with immune checkpoint modulator (ICM) therapy in patients with melanoma.
Read More