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An Evidence-Based Review On The Use Of Perampanel For The Treatment Of Focal-Onset Seizures In Pediatric Patients

Authors Dozières-Puyravel B, Auvin S

Received 24 June 2019

Accepted for publication 31 August 2019

Published 24 September 2019 Volume 2019:15 Pages 2789—2798

DOI https://doi.org/10.2147/NDT.S178405

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Prof. Dr. Roumen Kirov

Peer reviewer comments 3

Editor who approved publication: Dr Roger Pinder


Blandine Dozières-Puyravel,1 Stéphane Auvin1,2

1Service de Neurologie Pédiatrique et des Maladies Métaboliques, Hôpital Robert Debré, Paris, France; 2Université Paris Diderot, Sorbonne Paris Cité, INSERM UMR 1141, Paris, France

Correspondence: Stéphane Auvin
Service de Neurologie Pédiatrique et des Maladies Métaboliques, CHU Hôpital Robert Debrém, 48, Boulevard Sérurier, Paris CEDEX 19- 75935, France
Tel +33 1 40 03 57 24
Fax +33 1 40 03 47 74
Email stephane.auvin@aphp.fr

Abstract: Perampanel, a non-competitive AMPA receptor antagonist, is a once-daily oral antiepileptic drug approved for the treatment of focal seizures and primary generalized tonic–clonic seizures in children 12 years of age and over. We conducted a systematic review of the data on perampanel in children and adolescents with focal-onset seizures. We found 21 published papers on the pediatric use of perampanel for focal-onset seizures, including 9 papers on clinical trials and ancillary studies of these trials, of which 2 focused on pharmacokinetics, 1 was a meta-analysis, and 9 were real-life studies (1 was prospective). Perampanel, as an adjunctive treatment for uncontrolled focal-onset seizures, results in an improvement of seizure control with a generally good safety profile. Evidence-based data are currently available for children 12 years of age and over. Higher amounts of perampanel might be required in patients taking enzyme-inducing antiepileptic drugs. The most common adverse events are somnolence, dizziness and behavioral adverse events. The latter seems more frequent in adolescents than in adults and in adolescents with preexisting behavioral comorbidities. Current studies did not identify any short-term impact of perampanel on cognitive functions. Its long half-life allows once-daily administration. Real-life studies further established that a decrease of the dose frequently resolves adverse events, as demonstrated in pivotal studies. Pharmacokinetic and safety studies are still ongoing in the younger population, down to 4 years of age, in order to apply for approval in this age group.

Keywords: antiepileptic drugs, children, epilepsy, focal onset seizure, perampanel

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