Long-term efficacy and safety of adjunctive perampanel in pediatric patients aged 4 – 19 years with drug-resistant epilepsy: a real-world study

This study determined a 24-month outcome of perampanel (PER) treatment in children and adolescents with drug-resistant epilepsy. The percentage of ≥50% responders was 47.3% at 12 months and 49.0% at 24 months. A 100% reduction in seizures for more than 12 months was observed in 36 patients (12.2%). Discontinuation occurred in 117 patients (39.8%). The most common reason for discontinuation was adverse events (34/117 patients, 11.6%). Baseline seizure frequency was higher in children aged <12 years than patients aged ≥12 years, however, the percentage of seizure reduction and ≥50% responders did not significantly differ between the two groups. The rate of early discontinuation was higher (p=<.001), and the duration of PER treatment was shorter in children aged <12 years (p=.001). The most common reason for discontinuation was significantly different. Most children aged < 12 years discontinued PER because of inadequate effectiveness, while the adverse event was the most common reason in patients aged ≥12 years (p=.045). Only the slow titration was significantly associated with ≥50% of the responder. PER is an effective anti-seizure drug that can be used safely on a long-term basis for pediatric patients aged 4 to <12 years and for patients aged ≥12 years.