A retrospective assessment of the Russian experience of using perampanel in everyday clinical practice as an adjunctive therapy drug in patients with focal epilepsy aged 12 years and older was carried out.

Patients and methods. A multicenter retrospective study was carried out, during which doctors filled out standard questionnaires with characteristics of the disease and the therapy being administered. The maximum observation period was 12 months. Each patient was included in the study only once for the duration of the study. 164 cases of pharmacoresistant focal epilepsy were analyzed. The average age of patients is 37.7 years, the ratio of men and women is 1: 1. The duration of the disease for more than 10 years was in 68.7% of patients; structural epilepsy was present in 68.2% (temporal localization of the focus - in 53.4% ​​and frontal - in 39.1%).

Results and discussion. Most patients (26.6%) were prescribed perampanel after three previous lines of therapy, the maximum number of drugs in combination before perampanel was 2 (50.9%) and 3 (29.6%). The baseline frequency of all types of seizures reached 9 [3; 34] per month, bilateral tonic-clonic with focal onset - 3 [2; 6] per month. On combined therapy with the inclusion of perampanel , it was possible to achieve the disappearance of all types of seizures in 22.7% of cases, responders (for all types of seizures) - 52.8%, and remission of bilateral tonic-clonic seizures was achieved in 60.8% of patients, responders - 27,8%. Retention on therapy by 12 months of observation - 80.7% (95% confidence interval 72.3-89.1). Adverse events (AEs) were observed in 31.3% of patients; the most common AEs were drowsiness (10.4%), aggression (9.8%), irritability (6.7%), other AEs were observed in isolated cases. The average dose of perampanel was 8 mg.

Conclusion. Perampanel proved to be effective in patients with resistant forms of focal epilepsy with a maximum follow-up period in routine clinical practice of 12 months. Remission of all types of seizures was achieved in 22.7% of cases, a decrease in the number of seizures - 50% - in 52.8%, and retention on therapy - in 80.7%. The drug had a therapeutic effect in all types of focal seizures and was most effective in bilateral tonic-clonic seizures with focal onset. Along with a good clinical effect, perampanel has demonstrated a predictable safety profile.

Source: Vlasov P.N., Karlov V.A., Zhidkova I.A., Dmitrenko D.V., Rudakova I.G., Danilova T.V., Kalinin V.A., Grebenyuk O.V., Herzen A P., Zhuravlev Ya.S., Karas A.Yu., Paramonova E.N., Ponomareva I.V., Miguskina O.I., Sobyanina N.A., Sukhova D.V., Salomatin Yu.V. ., Ertakhova M.L., Goguadze T.M., Shamray A.P. Russian retrospective multicenter open observational study based on data from medical documentation on the use of the drug perampanel in everyday clinical practice // Neurology, neuropsychiatry, psychosomatics. 2020. No. 3. URL: https://cyberleninka.ru/article/n/rossiyskoe-retrospektivnoe-mnogotsentrovoe-otkrytoe-nablyudatelnoe-issledovanie-na-osnove-dannyh-meditsinskoy-dokumentatsii-po  (date accessed: 27.06.2021).