Perampanel in patients with brain tumor-related epilepsy in real-life clinical practice: a retrospective analysis. (3rd June 2019)

• Record Type: Journal Article
• Authors: Maschio, Marta; Pauletto, Giada; Zarabla, Alessia; Maialetti, Andrea; Lus, Tamara; Villani, Veronica; Fabi, Alessandra; Koudriavtseva, Tatiana; Giannarelli, Diana
• Is Part Of: International journal of neuroscience. Volume 129:Number 6(2019)
• Page Start: 593
• Page End: 597
• Publication Date: 2019-06-03
• Subjects: Antiepileptic drugs -- brain tumor-related epilepsy -- molecular factors -- perampanel -- responder rate; Nervous system -- Periodicals; 612.805
• DOI: 10.1080/00207454.2018.1555160
• Languages: English
• ISSNs: 0020-7454

Abstract

Abstract: Introduction: Epilepsy occurs in 35–70% of patients with gliomas; glutamate plays a central role via AMPA-receptor activation, which is involved both in seizure activity and tumor growth. We conducted a retrospective study on brain tumor-related epilepsy patients (BTRE) treated with perampanel in add-on (PER) for 12 months, to evaluate efficacy and tollerability, according to real-life clinical practice. Materials and methods: Medical records of eleven patients (9 males, mean age 54 years) with glioma and epilepsy treated with PER in add-on, for inadequate seizure control or adverse events (AEs) from previous antiepileptic drugs (AEDs) therapy, were reviewed. Data collected included: tumor history, molecular factors, systemic therapy, type and number of seizures and concomitant AEDs, and AEs. Results: After 12 months of PER therapy, five patients were seizure-free, 4 had a seizure reduction ≥50% and the seizure frequency was unchanged in 2 patients. Responder rate was 81.8%. Two patients reported AEs; PER dose was reduced only in the one case. The final median dose of PER was 7.3 mg/day. We didn't find statistically significant differences in the comparison between mean values pre, mean values post and the average of decreasing number of seizures related to: histology, presence/absence of chemotherapy, radiotherapy, progression disease, KPS, IDH1, MGMT. Discussion: Despite the limitations due to small number of patients in a retrospective study, the high rate of responder and seizure-free patients suggest that PER could be a therapeutic option in BTRE. Prospective controlled studies are needed to confirm our data.