Perampanel in children with refractory epilepsy

Abstract

Introduction: Approximately 30% of children with epilepsy, will develop drug-resistance and will fail to achieve satisfactory control of their seizures. New antiepileptic drugs may benefit patients with uncontrolled epilepsy. Perampanel is a selective antagonist of AMPA-type glutamate receptor, approved as adjunctive therapy for the treatment of partial-onset seizures with or without secondary generalized seizures and in idiopathic generalized epilepsy, in patients aged ≥12 years. Data on perampanel efficacy and tolerability in children are sparse. Objective: To assess the effectiveness and safety of perampanel as an adjunctive therapy in children and adolescents with drug-resistant epilepsy. Methods: We collected retrospective data on 5 children treated with add-on PER, monitored in the department of pediatric neurology in Children's Hospital ‘P. & A. Kyriakou', Athens, Greece. As PER is not licensed for children younger than 12 years, it was used as a rescue therapy in patients with particularly aggressive disease. Results: Two patients experienced significant improvement of their seizures (one became seizure free), one experienced mild deterioration and three patients did not experience any change. PER was well-tolerated by all subjects and no side effects were reported. Conclusion: PER may be useful in the treatment of selected children with difficult epilepsy. As it is well tolerated and has minimal propensity to cause pharmacokinetic interactions, it could be safely tried especially in multi-drug treatment settings.