ArticleDrugs & aging2021
Adjunctive Perampanel in Older Patients With Epilepsy: A Multicenter Study of Clinical Practice.
Article in Drugs & aging, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 39 citations in OpenAlex.
- Efficacy and tolerability of perampanel in patients with seizures in real-world clinical practice: A systematic review and meta-analysis.Frontiers in pharmacology · 2023Pooled it
- Antiseizure Medications in Older Adults with Epilepsy: Considerations in Pharmacology, Safety, Tolerability, and Effectiveness of Newer Agents.Drugs & aging · 2026Review
- Long-term efficacy and safety of perampanel in patients aged 60 years and older with focal seizures: Post hoc analysis of phase III open-label extension studies stratified by enzyme-inducing anti-seizure medication use.Epilepsy & behavior reports · 2025Article
- Real-world use of adjunctive perampanel for focal-onset seizures in Italy: A mirroring clinical practice study of perampanel in adults and adolescents (AMPA).Epilepsia open · 2025Observational
- Effectiveness of perampanel as only concomitant antiseizure medication for highly active epilepsy: insight from a real-world, multicenter retrospective study.Journal of neurology · 2025Observational
- Observational
- Efficacy of Perampanel in Refractory and Super-Refractory Status Epilepticus with Suspected Inflammatory Etiology: A Case Series.Pharmaceuticals (Basel, Switzerland) · 2023Article
- Five-Year Retention of Perampanel and Polytherapy Patterns: 328 Patients From a Single Center in South Korea.Journal of clinical neurology (Seoul, Korea) · 2023Article
- Efficacy and Tolerability of Perampanel in Brain Tumor-Related Epilepsy: A Systematic Review.Biomedicines · 2023Review
- Efficacy and tolerability of perampanel: a Chinese real-world observational study in epilepsy.Frontiers in neurology · 2023Article
- Scoping review of rational polytherapy in patients with drug-resistant epilepsy.Pharmacotherapy · 2023Article
- The broad-spectrum activity of perampanel: state of the art and future perspective of AMPA antagonism beyond epilepsy.Frontiers in neurology · 2023Review
- Brivaracetam as Early Add-On Treatment in Patients with Focal Seizures: A Retrospective, Multicenter, Real-World Study.Neurology and therapy · 2022Article
- Effects of Perampanel on Seizure Control, Cognition, Behavior, and Psychological Status in Patients With Epilepsy: A Systematic Review.Journal of clinical neurology (Seoul, Korea) · 2022Article
- Sustained seizure freedom with adjunctive brivaracetam in patients with focal onset seizures.Epilepsia · 2022Article
- Optimal Use of Perampanel in Elderly Asian Patients with Epilepsy: Expert Opinion.Therapeutics and clinical risk management · 2022Article
- Posterior cingulate cortex reveals an expression profile of resilience in cognitively intact elders.Brain communications · 2022Article
- Can Old Animals Reveal New Targets? The Aging and Degenerating Brain as a New Precision Medicine Opportunity for Epilepsy.Frontiers in neurology · 2022Review
- The clinical correlation between Alzheimer's disease and epilepsy.Frontiers in neurology · 2022Review
- [Guidelines for the management of adverse effects of anti-seizure medications (2023)].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatricsArticle
Corrections and comments
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Authors and funding
19 authors at 12 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundClinical data regarding use of newer antiseizure medications (ASMs) in an older population are limited. In randomized-controlled, placebo-controlled trials, older patients are under-represented, and protocols deviate markedly from routine clinical practice, limiting the external validity of results. Studies performed in a naturalistic setting are a useful complement to characterize the drug profile. Perampanel is a third-generation ASM and the first and only non-competitive alfa-amino-3-hydroxyl-5-methyl-4-isoxazole-propionate receptor antagonist.
objectiveThe aim of this study was to assess the effectiveness and tolerability of adjunctive perampanel over a 1-year period in a population of older patients with epilepsy treated in a real-world setting.
methodsOlder (≥ 65 years of age) patients prescribed add-on perampanel at 12 Italian epilepsy centers were retrospectively identified. Seizure occurrence, adverse events (AEs), and drug withdrawal were analyzed. Effectiveness outcomes included the rates of seizure response (≥ 50% reduction in baseline monthly seizure frequency), seizure freedom, and treatment discontinuation. Safety and tolerability outcomes were the rate of treatment discontinuation due to AEs and the incidence of AEs.
resultsA total of 92 patients with a median age of 69 (range 65-88) years were included. The median daily dose of perampanel at 12 months was 6 mg (interquartile range 4-6 mg). At 12 months, 53 (57.6%) patients were seizure responders, and 22 (23.9%) patients were seizure free. Twenty (21.7%) patients discontinued perampanel; the reasons for treatment withdrawal were insufficient efficacy (n = 6/20; 30.0%), AEs (n = 12/20; 60.0%), and a combination of both (n = 2/20; 10%). The most common AEs included irritability (8.7%), somnolence (4.3%), and dizziness/vertigo (4.3%). The rate of behavioral and psychiatric AEs was higher in patients with history of psychiatric comorbidities (p = 0.044). There were no differences in the occurrence of behavioral and psychiatric AEs according to the concomitant use of levetiracetam (p = 0.776) and history of cognitive decline (p = 0.332).
conclusionsAdjunctive perampanel was associated with improvement in seizure control and good tolerability in a real-life setting and can represent a viable therapeutic option in older patients with epilepsy.
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