Sleep quality and daytime sleepiness in patients treated with adjunctive perampanel for focal seizures

Toledo, Manuel; González-Cuevas, Montserrat; Miró-Lladó, Julia; Molins-Albanell, Albert; Falip, Mercé; Martínez, Ana Belén; Fernández, Santiago; Quintana, Manuel; Cambrodí, Roser; Santamarina, Estevo; Salas-Puig, Javier

doi:10.1016/j.yebeh.2016.08.004

Cited by 38 publications

(25 citation statements)

References 16 publications

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“…36 Consistently, previous reports documented that PER does not worsen daytime sleepiness at 3 months. 37,38 In agreement with these data, the acceleration of EEG background activity in patients treated by PER may represent the electrophysiological basis of this finding.…”

Section: Discussionsupporting

confidence: 75%

Perampanel Increases Cortical EEG Fast Activity in Child and Adult Patients Affected by Epilepsy: A Quantitative EEG Study

et al. 2020

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Objective Quantitative EEG (qEEG) is an established technique used as objective measure for evaluating the effect of antiseizure medications (ASMs) on EEG background activity and monitoring cognitive effects of ASMs. Perampanel (PER) has been associated with relatively more tolerable cognitive effects in patients with epilepsy. The primary aim of the present study was to verify the effect of PER as first add-on ASM on qEEG in child and adult patients affected by epilepsy. The secondary aim of this study was to verify the effectiveness of the drug as first add-on treatment in both child and adult patients with epilepsy. Methods We collected data from 17 adults and 10 children treated with PER as first add-on treatment, who underwent qEEG analysis before starting PER and at 3-month follow-up under stable treatment. Results PER resulted with significant effectiveness in reducing seizures in both children and adults. Considering qEEG analysis, we observed at follow-up the significant increase in beta1 and beta total bands both in children and adult patients. In particular, children showed the significant increase of beta band frequencies predominantly in the occipital regions, whereas adults showed a widespread increase of beta activity. Moreover, we documented in both child and adult patients the global reduction of delta bands activity. Conclusions This qEEG study documented the relative increase of cortical EEG fast activity in both children and adult patients affected by epilepsy and treated by PER. This result may suggest a potential less negative impact of PER on cognition in patients affected by epilepsy, other than demonstrating effectiveness of the drug when used as first add-on treatment in both children and adult patients.

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Section: Discussionsupporting

confidence: 75%

Perampanel Increases Cortical EEG Fast Activity in Child and Adult Patients Affected by Epilepsy: A Quantitative EEG Study

et al. 2020

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“…Between 50 and 70% of participants reported at least 1 adverse event during perampanel treatment in most observational studies, and up to 81% in a refractory population with intellectual disability . Dizziness is reported at a consistent rate of 14‐18% which is much lower than in clinical trials (32% with 8 mg perampanel) . This is probably due to slower titration in routine use than the 2 mg every week used in the trials.…”

Section: Discussionmentioning

confidence: 97%

“…5,43 It is important to note that we did not see any previously unknown adverse reactions, and our overall adverse event rates were consistent with previous reports. Between 50 and 70% of participants reported at least 1 adverse event during perampanel treatment in most observational studies, 35,[39][40][41][42]44 and up to 81% in a refractory population with intellectual disability. 34 Dizziness is reported at a consistent rate of 14-18% [34][35][36]39,41,42,44 which is much lower than in clinical trials (32% with 8 mg perampanel).…”

Section: Discussionmentioning

confidence: 99%

Perampanel in routine clinical use across Europe: Pooled, multicenter, observational data

et al. 2018

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Across a large, treatment-resistant population, add-on perampanel was retained for ≥1 year by 48% of individuals, and 9% were seizure-free for ≥6 months. TEAEs were in line with previous reports in routine clinical use, and less frequent than in the clinical trial setting. No new or unexpected TEAEs were seen. Despite the limitations of observational studies, our data indicate that some individuals may derive a marked benefit from the use of perampanel.

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“…Preliminary evidence suggests that adjunctive perampanel in patients with focal seizures does not worsen sleep quality or daytime sleepiness after 3 months of treatment, and in fact reduces daytime sleepiness after 6 months of continued treatment [15]. In addition, lowdose perampanel is also reported to be a potential drug candidate for the treatment of idiopathic RLS [16].…”

Section: Introductionmentioning

confidence: 99%

Perampanel effect on sleep architecture in patients with epilepsy

Rocamora

Álvarez

Chavarría

et al. 2020

Seizure

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Among patients with epilepsy, sleep disturbances can worsen seizure control. This prospective openlabel study determined the effect of the antiepileptic drug perampanel on sleep architecture in patients with refractory epilepsy. Methods: Adult patients with refractory epilepsy received add-on perampanel, starting at 2 mg/day at bedtime, increased by 2 mg after 2 weeks and then monthly until the target dose of 4-8 mg/day was reached. The median dose of perampanel used was 6 mg (SD 1.2). Polysomnographic (PSG) recordings were scheduled 1 week before starting perampanel and the control PSG after 12 weeks under perampanel treatment and at least 4 weeks on stable perampanel dose; patients completed the Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI) questionnaires. The main endpoints were change from baseline in the ESS and PSQI scores, and PSG variables. Results: Of 25 patients included (aged 18-65 years, 56 % female) only 17 completed the study. Perampanel caused a modest decrease from baseline in mean ESS score (n = 13 patients; p = 0.126) and PSQI score (n = 12 patients; p = 0.127). Treatment significantly improved sleep parameters (n = 17 patients) including total sleep time (p = 0.037), sleep latency (p = 0.022), sleep efficiency (p = 0.015), sleep maintenance index (p = 0.005), wake time after sleep onset (p = 0.015), and duration of N3 sleep stage (p = 0.026). Patients with altered sleep efficiency parameters at baseline showed a significant increase in sleep maintenance index (p = 0.015), and 77.8 % achieved sleep efficiency > 85 % (p = 0.016 vs baseline). Conclusion: Perampanel improved sleep architecture in patients with focal refractory epilepsy without worsening daytime sleepiness.

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Sleep quality and daytime sleepiness in patients treated with adjunctive perampanel for focal seizures

Cited by 38 publications

References 16 publications

Perampanel Increases Cortical EEG Fast Activity in Child and Adult Patients Affected by Epilepsy: A Quantitative EEG Study

Perampanel Increases Cortical EEG Fast Activity in Child and Adult Patients Affected by Epilepsy: A Quantitative EEG Study

Perampanel in routine clinical use across Europe: Pooled, multicenter, observational data

Perampanel effect on sleep architecture in patients with epilepsy

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