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Long-term effectiveness of add-on perampanel in patients with Lennox-Gastaut syndrome: a multicenter retrospective study.

Sara MatricardiElisabetta CesaroniPaolo BonanniNicoletta FoschiAlfredo D'AnielloGiancarlo Di GennaroPasquale StrianoSilvia CappaneraSabrina SiliquiniElena FreriFrancesca RagonaTiziana GranataFrancesca AnzellottiFlavio VillaniAngelo RussoTullio MessanaLaura SiriIrene BagnascoAglaia VignoliFrancesca Felicia OpertoAlessandro OrsiniAlice BonuccelliAmanda PapaCinzia PeruzziClaudio LiguoriAlberto VerrottiFrancesco ChiarelliCarla MariniSimona Lattanzi
Published in: Epilepsia (2023)
This retrospective study assessed long-term effectiveness of add-on perampanel (PER) in patients with Lennox-Gastaut syndrome (LGS). Outcomes included time to PER-failure and time to seizure-relapse in responders. Perampanel failure was defined as either discontinuation of PER or initiation of another treatment. Seizure relapse in responders was defined as occurrence of a seizure in seizure-free patients and increase of at least 50% in average monthly seizure frequency for those who were responders. Eighty-seven patients were included. Treatment failure occurred in 52 (59.8%) subjects at a median time of 12 months. Treatment failure was due to lack of efficacy in 27 (52.0%) patients, lack of tolerability in 14 (27.0%), and both reasons in 11 (21.0%). A slower titration was associated with a lower risk of PER failure compared to faster titration schedules and the occurrence of adverse events increased the risk of treatment failure. Thirty-six patients (41.4%) were responders during a median follow-up of 11 months. Seizure relapse occurred in 13/36 (36.1%) patients after a median time of 21 months. The overall rate of seizure responders was 23/87 (26.4%) at the end of follow-up. This study provides real-world evidence about the effectiveness of PER as adjunctive treatment in LGS patients.
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