A META-ANALYSIS OF THE EFFICACY AND SAFETY OF ADJUNCTIVE PERAMPANEL FOR THE TREATMENT OF REFRACTORY FOCAL-ONSET SEIZURES IN EPILEPTIC PATIENTS

Abstract

The usage of anti-seizure medications (ASMs) has increased over the previous decade, yet the burden of treating drug-resistant epilepsy has not decreased. This meta-analysis was carried out to determine the best dose of Perampanel (PER) as a new adjunctive treatment for drug-resistant seizures.

Method

We examined through ScienceDirect, PubMed, and the Central Register of Controlled Trials (CENTRAL) for research that had been published between their start and February 1, 2021. characteristics of the research, patients, and treatment regimen, concurrent ASMs, and clinical results were taken out. The practical result was a 50%, 75%, or 100% decrease in the frequency of convulsive seizures, and the safety result was the percentage of drug withdrawal and negative side effects. The inverse variance approach was used to estimate odds ratios (OR) for 95% confidence intervals (CI).

Result

Four trials totalled 2187 people (1569 in the PER group and 618 in the placebo group). Results revealed that 8 or 12 mg per day had the greatest impact on all three outcomes, with no statistically significant difference between 8 and 12 mg per day (seizure-free, 3.5% vs. 3.7%, P =.85); 50% reduction, 35.5% vs. 36.1%; 75% reduction, 17.8% vs. 19.1%). Additionally, a larger percentage of treatment-emergent adverse events (TEAE) that led to dosage reduction or discontinuation occurred with 12-mg PER compared to 8-mg (8.7% vs. 17.0%; P .00001). Dizziness, somnolence, weariness, and irritability were the reported adverse events (AEs) (significantly linked with adjunctive PER).

Significance

In patients with refractory epilepsy, adjunctive treatment with PER was related to a greater reduction in seizure frequency than placebo and a higher frequency of adverse events (AEs). For the majorityof research participants, PER at a dose of 8 mg per day appeared to have the best efficacy-to-tolerance ratio.