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30 June 2014

Once daily perampanel shows good results

An epilepsy expert from France has told how a politician in his home country travels hundreds of kilometres for his neurology appointments  because he does not want his constituents to know he has epilepsy.

Speaking at the 11th European Congress on Epileptology in Stockholm, Sweden, Dr Arnaud Biraben told how the condition is still highly stigmatised worldwide and underlined the need for medications and treatments that would improve seizure control and quality of life, and reduce stigma.

The congress is an opportunity for experts in the field of epilepsy from across Europe to share the latest diagnostic techniques, treatments and research into the condition.

Dr Biraben is an epileptologist at Rennes University Hospital, France and president of the French League against Epilepsy. He was speaking as part of a presentation on the clinical data and real world experiences of people prescribed the latest anti-epileptic drug perampanel .

Real world experiences

Ten observational studies looking at the real world experience of people taking the drug, have shown that the medication is generally effective and well tolerated.

Perampanel  is an add-on treatment for partial onset seizures, with or without secondarily generalised seizures. It has been developed by the pharmaceutical company Eisai.  Clinical trials have already shown that long-term prescribing of the medication provides a sustained reduction in seizures over two years, with people experiencing up to a 90 per cent reduction in secondarily generalised seizures.

Clinical trials have also supported the use of perampanel in young people over the age of 12, although some aggressive and hostile behaviour has been observed in a minority of adolescents taking the drug.

But clinical trials are carried out in standardised conditions, excluding some patients and situations. Real world experience complements clinical data by providing a valuable insight into how epilepsy treatments affect different patients and helps to inform on the newer epilepsy drugs.

The real world experience studies, supported by Eisai,  looked at 350 people with uncontrolled seizures across the UK and Austria. This involved people in a variety of patient populations including those with highly refractory epilepsy, accompanying illnesses and those in both paediatric and routine neurology clinics.

Most side effects reported were considered mild or moderate, with the most common being, dizziness, somnolence and headache.

Weight gain

Two further studies  - one led by Epilepsy Society's head of therapeutic drug monitoring, Professor Philip Patsalos - showed that perampanel did not affect blood cholesterol, triglyceride and glucose levels, though the drug did result in a small increase in weight gain.

Dr Biraben told delegates: 'There is a huge stigma surrounding epilepsy. Just one seizure a year can impact on driving, employment and social life. This is particularly important for young people who are establishing careers and wanting to socialise.

'Perampanel is a once-a-day drug, taken at bedtime.  This helps to increase adherence, optimise seizure control and reduce both the impact on quality of life and epilepsy stigma.'

Perampanel  has been licensed in the UK since 2012 as Fycompa and is the only AED  to selectively target AMPA receptors, a protein in the brain that plays  a critical role in the spread of seizures.

It is the only new generational partial onset epilepsy treatment approved to treat adolescents over the age of 12 from its launch.