The use of perampanel in drug-resistant focal epilepsy: its effect on sleep

Filin, Anatoly; Tardov, M V; Kunelskaya, N. L.; Власов, П. Н.

doi:10.14412/2074-2711-2020-6-49-53

Cited by 3 publications

(1 citation statement)

References 13 publications

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“…Serving as an inhibitor of AMPA‐type glutamate receptors, perampanel (PER) has a positive effect on sleep architecture in drug‐resistant focal epilepsy. Acute adjunctive PER treatment decreased daytime sleepiness ( n = 12, 4 weeks) 30 ; chronic administration of PER had minimal influence on daytime vigilance ( n = 17, 12 weeks; n = 72, 12 weeks) 31,32 and longer‐term administration further improved daytime sleepiness ( n = 31, 24 weeks) 32 . Another study reported a 12‐week treatment of PER had no apparent effect on sleep in 10 epilepsy patients without apparent previous sleep disorders 33 .…”

Section: Anti‐seizure Medicationsmentioning

confidence: 98%

Effects of anti‐seizure therapies on sleep in patients with epilepsy: A literature review

Chen

et al. 2022

Acta Neuro Scandinavica

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Sleep disorder is common in epilepsy. With a recent rapid development in sleep medicine, it has been increasingly recognized that anti‐seizure therapies, either anti‐seizure medications (ASMs) or non‐pharmaceutical approaches, can take direct or indirect influence on sleep in patients with epilepsy. Here, we systematically review the effect of anti‐seizure treatments on sleep. ASMs targeting at different sites exerted various effects on both sleep structure and sleep quality. Non‐pharmaceutical treatments including resective surgery, ketogenic diet, and transcranial magnetic stimulation appear to have a positive effect on sleep, while vagus nerve stimulation, deep brain stimulation, and brain‐responsive neurostimulation are likely to interrupt sleep and exacerbate sleep‐disordered breathing. The potential mechanisms underlying how non‐pharmacological approaches affect sleep are also discussed. The limitation of most studies is that they were largely based on small cohorts by short‐term observations. Further well‐designed and large‐scale investigations in this field are warranted. Understanding the effect of anti‐seizure therapies on sleep can guide clinicians to optimize epilepsy treatment in the future.

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Section: Anti‐seizure Medicationsmentioning

confidence: 98%

Effects of anti‐seizure therapies on sleep in patients with epilepsy: A literature review

Chen

et al. 2022

Acta Neuro Scandinavica

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Observational study of the effect of perampanel on sleep and daytime sleepiness in adult patients with epilepsy in real-life clinical practice

Vlasov,

Karlov,

Zhidkova

et al. 2024

RJTAO

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Sleep disorders occur twice as often in epilepsy patients compared to healthy people and have a negative impact on seizure control and general quality of life. International and Russian publications on the effect of perampanel (PER) on sleep emphasise the positive effect of the drug on sleep quality, daytime sleepiness and sleep architecture.Objective: to evaluate the effect of PER (Fycompa®) on sleep quality and daytime sleepiness when used as an adjunct antiepileptic drug (AED) in the treatment of epilepsy in adults.Material and methods. The study included 106 patients aged 18 to 73 years with absolute predominance of focal epilepsy (n=96) who were prescribed PER as an adjunctive AED when previous therapy was insufficient, regardless of whether or not complaints of insomnia were present. The study was conducted from April 2022 to June 2023. The maximum observation period was 12 months. The study was multicenter (10 Russian clinical centres) and designed as an observational study, with patients being monitored prospectively, but some of the indicators were collected retrospectively, taking into account the conditions of real-life clinical practice. We assessed: sleep quality using the Pittsburgh Insomnia Scale (Ya.I. Levin modification), daytime sleepiness according to the Epworth scale, anxiety/depression level (Hospital Anxiety and Depression Scale, HADS), adverse events (AEs), efficacy/tolerability of combination therapy with PER for epilepsy at baseline, and after 1, 3, 6 and 12 months of therapy based on the number of completed questionnaires at each visit in the real-life clinical practice.Results. After a follow-up period of 12 months, the retention rate for complex therapy with PER was 84.9%. PER was discontinued in 15.1% of patients and in only 5.7% due to AEs. The most common AE was dizziness, which was observed with a frequency of over 10% (n=21), followed by irritability (n=9) and drowsiness (n=9) with the same frequency. No new, previously undescribed AEs were observed in this study. The use of PER as an additional AED led to a significant reduction in daytime sleepiness and an improvement in sleep quality after the first month of use; by the 12-month follow-up period, the daytime sleepiness index gradually decreased and reached normal levels, and sleep quality improved. The use of PER as part of a complex therapy led to a significant reduction in the initially elevated anxiety level.Conclusion. The use of PER as an additional AED in adults in dynamics significantly improves sleep quality and reduces daytime sleepiness after the first month of use, regardless of the duration of the disease and the order of PER administration. The use of PER as part of a complex therapy led to a decrease in the initially elevated anxiety level from subclinical to normal.

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The first combined Russian experience of using perampanel in children and adolescents with epilepsy in everyday clinical practice

Rakhmanina

Volkov

Volkova

et al. 2022

Rus. ž. det. nevrol.

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Background. Real world data help to provide more information on the effects and tolerability of therapy. However, data on the use of perampanel in Russian population of children remain limited.Aim. To conduct a retrospective analysis of perampanel efficacy and tolerability in children and adolescents with epilepsy in real clinical practice.Materials and methods. A total of 106 children aged 4–18 years receiving perampanel as part of combination therapy for epilepsy were observed at 18 centers. Seizure frequency at 1–3, after 6 and 12 months of treatment, presence and type of adverse events (AEs) were analyzed. The main assessed efficacy parameters were seizure control, significant (≥50 %) decrease in seizure frequency. All other outcomes (<50 % decrease, no change or increased seizure frequency) were considered to be no effect. The assessed safety parameters were the percentage of patients with or without AEs and the percentage of perampanel withdrawals due to AEs.Results. We defined 3 age groups for comparison: children 4–6, 7–11 and 12–17 years old. Perampanel efficacy was 69 % (seizure control – 23.6 %, ≥50 % decrease in seizure frequency – 45.3 %). The mean duration of the effect was 7.3 ± 4.1 months. No significant difference in efficacy between age groups was found. However, some greater efficacy of perampanel was noted in adolescents: absence of effect in the form of remission or significant decrease in seizures frequency was noted only in 25.5 %, with 40 % in children 4–11 years old. Among those with inefficacy, 3.8 % reported seizure aggravation. AEs occurred in only 23 % of patients, with the least frequent occurrence in adolescents (11.8 %) and the most frequent in children aged 7–11 years (40 %). The most frequent AEs was sluggishness and/or drowsiness. Discontinuation of perampanel due to AEs was required in 7.6 %.Conclusion. Perampanel has demonstrated high efficacy and good tolerability in real clinical practice among children from 4 years of age and adolescents with partial (focal) and secondary generalized seizures. The AEs that developed were not serious and very rarely led to withdrawal of the therapy. The results are comparable to those of phase III studies and previous real-world data. The usage of perampanel in children with primary generalized seizures should be further investigated.

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The use of perampanel in drug-resistant focal epilepsy: its effect on sleep

Cited by 3 publications

References 13 publications

Effects of anti‐seizure therapies on sleep in patients with epilepsy: A literature review

Effects of anti‐seizure therapies on sleep in patients with epilepsy: A literature review

Observational study of the effect of perampanel on sleep and daytime sleepiness in adult patients with epilepsy in real-life clinical practice

The first combined Russian experience of using perampanel in children and adolescents with epilepsy in everyday clinical practice

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