New Review Entitled Reflections on the Use of Perampanel in Epilepsy - Lessons from the Clinic and Real-world Evidence

LONDON, September 19, 2017 /PRNewswire/ --

Eugen Trinka, Mar Carreno, European Neurological Review, 2017;12(1):17-23 DOI: https://doi.org/10.17925/ENR.2017.12.01.17

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Published recently in European Neurological Review the peer-reviewed journal from touchNEUROLOGY, Trinka et al, discuss how optimal epilepsy management includes five important elements: rational treatment selection, efficacy, off-target effects, adherence and interactions and dosing issues. Perampanel (2- [2-oxo-1-phenyl-5-pyridin-2-yl-1,2-dihydropyridin-3-yl]benzonitrile; E2007) is the first potent, selective, orally-active non-competitive alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor antagonist approved for the treatment of patients with epilepsy. Results from randomised controlled trials and real-world studies of refractory epilepsy populations treated with perampanel showed effective frequency reduction for both focal-onset seizures (without and with secondary generalisation) and for primary generalised tonic-clonic seizures. Perampanel therapeutic doses have been calculated to only inhibit a fraction of AMPA receptors, thereby to enable sufficient seizure control without substantial impairment of neurological function. Further investigation in special subpopulations of people with epilepsy, including the elderly and people with learning disability or psychiatric comorbidities, is warranted. With an average long half-life of 105 hours, perampanel may be more forgiving in circumstances of suboptimal adherence. Perampanel is not a strong inducer or inhibitor of cytochrome P450 enzymes, and dose adjustment is not always required for the elderly or for those with mild renal impairment.

The full peer-reviewed, open-access article is available here:

https://doi.org/10.17925/ENR.2017.12.01.17

Disclosure: Professor Eugen Trinka is a paid consultant for UCB, Eisai, Bial, Medtronic, EVER Neuro Pharma, Biogen-Idec, Sanofi-Genzyme, Shire, Marinus, Takeda, Newbridge and Sunovion. Professor Trinka has received research funding (directly, or to institution) from GlaxoSmithKline, Biogen-Idec, Eisai, Novartis, Red Bull, Bayer, and UCB Pharma Ltd, and speaker's honoraria from GlaxoSmithKline, Boehringer Ingelheim, Eisai, Bial, UCB Pharma Ltd, Sanofi-Genzyme, Shire and Sanofi-Aventis. He is the chief executive officer of Neuroconsult GmbH and has been awarded grants from the Austrian Science Fund (FWF), Osterreichische Nationalbank, European Union. Dr Mar Carreno has received advisory board or speaker's honoraria from Shire, Bial, Eisai, Esteve, and UCB Pharma Ltd and has received research grants from Bial and Eisai. There were no publication fees associated with the publication of this article.

touchNEUROLOGY (a division of Touch Medical Media) publishes European Neurological Review, a peer-reviewed, open access, bi-annual journal specialising in the publication of balanced and comprehensive review articles written by leading authorities to address the most important and salient developments in the field of neurology. The aim of these reviews is to break down the high science from 'data-rich' primary papers and provide practical advice and opinion on how this information can help physicians in the day to day clinical setting. Practice guidelines, symposium write-ups, case reports, and original research articles are also featured to promote discussion and learning amongst physicians, clinicians, researchers and related healthcare professionals.

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