Evaluation of the efficacy and tolerability of perampanel in the adjunctive therapy of epilepsy in somatically healthy and comorbid patients


Citar

Texto integral

Acesso aberto Acesso aberto
Acesso é fechado Acesso está concedido
Acesso é fechado Acesso é pago ou somente para assinantes

Resumo

Background. Many years of experience in the study of epilepsy and comorbid diseases, the treatment of patients with a combination of such conditions is a problem in real clinical practice. Comorbid diseases are often underestimated by clinicians; as a result, patients do not receive proper comprehensive treatment. And it is a common fact that, the number of chronic diseases in patients inevitably increases with age. Objective. Evaluation of the course of various forms of epilepsy in adult patients against the background of addition of perampanel to therapy and to evaluation of its impact on comorbid pathology in real clinical practice. Methods. The observation was carried out in real-life clinical settings; the patient enrollment was carried out by a random method during their routine examination. Patients with epilepsy aged >18 years, somatically healthy and with comorbid pathology, who were prescribed perampanel as additional therapy, were included in the study. Complaints, somatic and neurological status, seizure diary, electroencephalogram parameters, treatment regimens, including doses and tolerability of antiepileptic drugs, were assessed at each visit. The quality of life was assessed using the QOLIE-31 questionnaire. Results. 51 patients participated in the clinical observation, 40 patients completed it. 12 months after the start of perampanel therapy, a significant decrease in the number of seizures was registered in 27 (67,5%) patients, among them 22 (55%) patients responded to therapy and 5 (12.5%) achieved pharmacological remission. Also, the quality of life significantly improved in patients. Side effects were not observed in 80% of patients; they occurred in 8 (20%), therefore 5 patients withheld therapy. The severity of side effects was regarded as mild and completely regressed after discontinuation of the drug. There was no negative effect of perampanel on concomitant comorbid pathology. Conclusion. Perampanel demonstrated a good efficacy and safety profile in the study patients, so it can be considered as the drug of choice in the adjunctive therapy of patients with epilepsy and comorbid somatic conditions.

Texto integral

Acesso é fechado

Sobre autores

Marina Vagina

Sverdlovsk Regional Clinical Hospital № 1

Email: marina19772008@yandex.ru
Cand. Sci. (Med.), Neurologist of the Highest Qualification Category Yekaterinburg, Russia

Bibliografia

  1. Asato M.R., Caplan R., Hermann B. P. Epilepsy and comorbidities - what are we waiting for? Epileps Behav. 2014;31:127-28. doi: 10.1016/j.yebeh.2013.11.027.
  2. Keezer M.R., Sisodiya S.M., Sander J.W.Comorbidities of epilepsy: current concepts and future perspectives. Lancet. Neurol. 2016;15(1):106-15. doi: 10.1016/S1474-4422(15)00225-2.
  3. Li T. Epilepsy and associated comorbidities. Neuropsychiat. (London). 2017;1(1):1-3.
  4. Giussani G., et al.Comorbidities in patients with epilepsy: Frequency, mechanisms and effects on long-term outcome. Epilepsia. 2021;62(10):2395-404. doi: 10.1111/epi.17022.
  5. Люкманов Р.Х., Римкевичус А.А., Шалиманова Е.В. и др. Двигательная нейрореабилитация у пациентов с эпилептическими приступами: ограничения методов, имеющих доказанную эффективность при инсульте. Эпилепсия и пароксизмальные состояния. 2021;13(1):51-64. doi: 10.17749/2077-8333/epi.par.con.2021.043.
  6. Лебедева А.В., Бурд С.Г., Власов П.Н. и др. Лечение эпилепсии, ассоциированной с первичными и метастатическими опухолями головного мозга. Эпилепсия и пароксизмальные состояния. 2021;13(3):286-304. doi: 10.17749/2077-8333/epi.par.con.2021.099
  7. Маслов Н.Е., Литвинова А.А., Ковалев П.С. и др. Посттравматическая эпилепсия: клинические, диагностические и терапевтические особенности. Эпилепсия и пароксизмальные состояния. 2021;13(4):377-92. doi: 10.17749/2077-8333/epi.par.con.2021.100
  8. Горлова Л.А., Шмелева О.О., Федоров Е.В. и др. Динамика эпилептического синдрома и когнитивно-поведенческих особенностей у детей с нейрональными и смешанными нейронально-глиальными опухолями головного мозга в ближайшем и отдаленном послеоперационных периодах. Эпилепсия и пароксизмальные состояния. 2021;13(4):339-48. doi: 10.17749/2077-8333/epi.par.con.2021.068
  9. Шнайдер Н.А., Петрова М.М., Петров К.В. и др. Нарушения сердечного ритма и проводимости при юношеской миоклонической эпилепсии: генетические предикторы. Эпилепсия и пароксизмальные состояния. 2020;12(4):237-47. doi: 10.17749/2077-8333/epi.par.con.2020.045.
  10. Шнайдер Н.А., Петрова М.М., Петров К.В., Насырова Р.Ф. Фармакологические предикторы нарушения сердечного ритма и проводимости при юношеской миоклонической эпилепсии. Эпилепсия и пароксизмальные состояния. 2021;13(2):168-79. doi: 10.17749/2077-8333/epi.par.con.2021.051.
  11. Suleymanova E.M. Behavioral comorbidities of epilepsy and neuroinflammation: Evidence from experimental and clinical studies. Epileps. Behav. 2021;117:107869.
  12. Маслова Н.Н., Скоробогатова В.А. Комплаенс в эпилептологии: современный взгляд на проблему и стратегии его оптимизации. Эпилепсия и пароксизмальные состояния. 2020;12(1):74-81. doi: 10.17749/2077-8333.2020.12.1.74-81.
  13. Маслова Н.Н., Литвинова А.А., Юрьева Н.В., Ковалев П.С. Комплаентность в эпилептологии. Как изменить ситуацию к лучшему. Эпилепсия и пароксизмальные состояния. 2021;13(2):157-67. doi: 10.17749/2077-8333/epi. par.con.2021.059.
  14. Fisher R.S., Cross J.H., French J.A., et al. Operational classification of seizure types by the International League Against Epilepsy: Position Paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017;58(4):522-30. doi: 10.1111/epi.13670.
  15. Fisher R.S., Cross J.H., D’Souza C., et al. Instruction manual for the ILAE 2017 operational classification of seizure types. Epilepsia. 2017;58(4):531-42. doi: 10.1111/epi.13671.
  16. Авакян Г.Н., Блинов Д.В., Лебедева А.В. и др. Классификация эпилепсии Международной Противоэпилептической Лиги: пересмотр и обновление 2017 года. Эпилепсия и пароксизмальные состояния. 2017;9(1):6-25. doi: 10.17749/2077 8333.2017.9.1.006-025
  17. Saadi A., Patenaude B., Mateen F.J. Quality of life in epilepsy-31 inventory (QOLIE-31) scores: A global comparison. Epileps. Behav. 2016;65:13-7.
  18. Государственный реестр лекарственных средств. Электронный ресурс: https://grls.rosminzdrav.ru/Grls_View_v2.aspx?routingGuid=af1b55d0-26eb-4fe3-b594-db3792f89e2f&t= (доступ в февраль 2022 г.).
  19. Santamarina E., Bertol V., Garayoa V., et al. Efficacy and tolerability of perampanel as a first add-on therapy with different anti-seizure drugs. Seizure. 2020;83:48-56. doi: 10.1016/j.seizure.2020.09.026.
  20. Abril Jaramillo J., Estévez Marla J.C., Girôn Übeda J.M., et al. Effectiveness and safety of perampanel as early add-on treatment in patients with epilepsy and focal seizures in the routine clinical practice: Spain prospective study (PERADON). Epileps. Behav. 2020;102:106655. doi: 10.1016/j.yebeh.2019.106655.
  21. Мухин К.Ю., Пылаева О.А. Применение перампанела (Файкомпы) в лечении эпилепсии (опыт Института детской неврологии и эпилепсии им. Святителя Луки). Русский журнал детской неврологии. 2014;9(4):14-9.
  22. Chen C.-Y, Matt L., Hell J.W., Rogawski M.A. Perampanel Inhibition of AMPA Receptor Currents in Cultured Hippocampal Neurons. PLoS One. 2014;9(9):e108021. doi: 10.1371/journal.pone.0108021.
  23. French J.A., Krauss G.L., Steinhoff B.J., et al. Evaluation of adjunctive perampanel in patients with refractory partial-onset seizures: results of randomized global phase III study 305. Epilepsia. 2013;54(1):117-25. doi: 10.1002/mds.23362.
  24. Rektor I., et al. Assessment of the long-term efficacy and safety of adjunctive perampanel in tonic-clonic seizures: Analysis of four open-label extension studies. Epilepsia. 2020;61(7):1491-502. doi: 10.1111/epi.16573.
  25. Steinhoff B.J., Patten A., Williams B., Malhotra M. Efficacy and safety of adjunctive perampanel 4 mg/d for the treatment of focal seizures: A pooled post hoc analysis of four randomized, double-blind, phase III studies. Epilepsia. 2020;61(2):278-86. doi: 10.1111/epi.16428.
  26. Hansen C.C., Ljung H., Brodtkorb E., Reimers A. Mechanisms Underlying Aggressive Behavior Induced by Antiepileptic Drugs: Focus on Topiramate, Levetiracetam, and Perampanel. Behav. Neurol. 2018:2064027. doi: 10.1155/2018/2064027.

Arquivos suplementares

Arquivos suplementares
Ação
1. JATS XML
Baixar

Declaração de direitos autorais © Bionika Media, 2022