title: Two-year real-world experience with perampanel in patients with refractory focal epilepsy: Austrian data.
abstract: BACKGROUND
  The aim of this study was to analyse registry data of seizure outcome and adverse events (AEs) for perampanel as add-on therapy in patients with focal epilepsy since its approval in 2012 for adjunctive treatment of focal epilepsy in patients ⩾12 years.
  
  
  METHODS
  A retrospective 2-year chart review of all patients receiving perampanel was carried out.
  
  
  RESULTS
  A total of 122 patients received perampanel [median treatment length: 20.1 (range: 3.4-26.8) months]; 71 (58%) remained on treatment at last follow up. Overall, 33 patients (27%) were seizure-free for ⩾3 months at last follow up; of these, eight were seizure free for ⩾3 times the longest interictal interval before perampanel therapy; 18 (15%) had reduced seizure frequency ⩾50%. A total of 58 (47%) had an AE and 34 (28%) withdrew from treatment because of AEs. AEs included dizziness (33%), fatigue (12%), psychiatric symptoms (8%), cognitive deficits (7%), speech problems (5%), nausea (4%) and gait problems (4%). AEs subsided in 17/18 patients (94%) following a 2 mg dose reduction. A total of 43 (35%) took a concomitant enzyme inducer. Patients not taking enzyme inducers were more likely to be seizure free (p= 0.002); there were no other between-group differences.
  
  
  CONCLUSIONS
  Perampanel was well tolerated and improved seizure control in 42% of patients (50- 100% reduction), with higher rates in those not receiving a concomitant enzyme inducer. AEs, particularly dizziness, were common but often disappeared with a slight dose reduction. The results are consistent with those from randomized controlled trials.
authors: Department of Neurology, Christian Doppler Medical Klinik of the Paracelsus Medical University Salzburg, Ignaz-Harrer-Straße 79, A-5020 Salzburg, Austria.
authors: Alexandra
authors: A
authors: Rohracher
authors: Department of Neurology, Christian Doppler Medical Klinik of the Paracelsus Medical University Salzburg, Salzburg, Austria.
authors: Gudrun
authors: G
authors: Kalss
authors: Department of Neurology, Christian Doppler Medical Klinik of the Paracelsus Medical University Salzburg, Salzburg, Austria.
authors: Markus
authors: M
authors: Leitinger
authors: Department of Neurology, Christian Doppler Medical Klinik of the Paracelsus Medical University Salzburg, Salzburg, Austria.
authors: Claudia
authors: C
authors: Granbichler
authors: Department of Neurology, Christian Doppler Medical Klinik of the Paracelsus Medical University Salzburg, Salzburg, Austria.
authors: Ildiko
authors: I
authors: Deak
authors: Department of Neurology, Christian Doppler Medical Klinik of the Paracelsus Medical University Salzburg, Salzburg, Austria.
authors: Judith
authors: J
authors: Dobesberger
authors: Department of Neurology, Christian Doppler Medical Klinik of the Paracelsus Medical University Salzburg, Salzburg, Austria.
authors: Giorgi
authors: G
authors: Kuchukhidze
authors: Department of Neurology, Christian Doppler Medical Klinik of the Paracelsus Medical University Salzburg, Salzburg, Austria.
authors: Aljoscha
authors: A
authors: Thomschewski
authors: Department of Neurology, Christian Doppler Medical Klinik of the Paracelsus Medical University Salzburg, Salzburg, Austria.
authors: Julia
authors: J
authors: Höfler
authors: Department of Neurology, Christian Doppler Medical Klinik of the Paracelsus Medical University Salzburg, Salzburg, Austria.
authors: Eugen
authors: E
authors: Trinka
keywords: clinical experience; efficacy; focal epilepsy; perampanel; tolerability