Investigation of efficacy, safety and tolerability of perampanel monotherapy in children with newly-diagnosed epilepsy in routine clinical practice in China: a multicenter prospective observational study.

IF 6.1 2区 医学 Q1 PEDIATRICS
Tao-Yun Ji, Yi-Feng Ding, Yu-Qin Zhang, Li Jiang, Guo Zheng, Rong Luo, Dan Sun, Feng Gao, Yu-Wu Jiang, Yi Wang
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Abstract

Background: Perampanel (PER) has gained interest as initial monotherapy for pediatric patients. Currently, there are limited studies on the PER monotherapy in treating pediatric patients with focal-onset seizures (FOS). This study aims to investigate efficacy and safety/tolerability of PER as initial monotherapy in treating pediatric patients with newly-diagnosed FOS in routine clinical practice in China.

Methods: This multicenter, prospective, real-world observational study enrolled 210 antiseizure medication-naïve patients aged 4-12 years with newly-diagnosed FOS who visited one of the eight tertiary hospitals in China during March-December 2023. All patients were treated with PER monotherapy. The primary endpoint was seizure-freedom rate (SFR) during weeks 13-26 of PER monotherapy. Furthermore, 50%, 75% responder rates and retention rate were assessed. An electronic seizure diary was used. Treatment-emergent adverse events (TEAEs) were recorded.

Results: The full analysis set included 203 patients. The SFR was 158/203, namely, 77.8% (95% confidence interval: 71.6%-83.0%) during weeks 13-26. The 50% and 75% responder rates were 88.2% and 85.2%, respectively, and the 26-week retention rate was 91.1%. Most patients received 2-6 mg/day maintenance PER and the 107 patients receiving 4 mg/day PER had the highest SFR (89.7%). Patients who had > 2 seizures during the three months before their enrollment were significantly less likely to be seizure free during weeks 13-26 than those who had ≤ 2 seizures. Seventy-nine (38.9%) patients had treatment-related TEAEs and most of them were mild and tolerable. Two (1.0%) patients withdrew from the study due to TEAEs. The most common TEAEs were dizziness, irritability, somnolence and fatigue.

Conclusions: PER as initial monotherapy was effective and tolerable in Chinese patients aged 4-12 years with newly-diagnosed FOS. No safety issues arose in our study.

一项多中心前瞻性观察研究:perampanel单药治疗中国新诊断癫痫儿童的常规临床疗效、安全性和耐受性
背景:Perampanel (PER)作为儿科患者的初始单药治疗已经引起了人们的兴趣。目前,关于PER单药治疗小儿局灶性癫痫(FOS)的研究有限。本研究旨在探讨在中国常规临床实践中,PER作为初始单药治疗儿科新诊断FOS患者的有效性和安全性/耐受性。方法:这项多中心、前瞻性、现实世界观察性研究纳入了210例4-12岁新诊断FOS的抗癫痫medication-naïve患者,这些患者于2023年3月至12月在中国8家三级医院之一就诊。所有患者均采用PER单药治疗。主要终点是PER单药治疗第13-26周的癫痫发作自由率(SFR)。此外,还评估了50%、75%的应答率和保留率。使用了电子扣押日记。记录治疗中出现的不良事件(teae)。结果:完整分析集包括203例患者。13-26周的SFR为158/203,即77.8%(95%置信区间:71.6% ~ 83.0%)。50%和75%应答率分别为88.2%和85.2%,26周保留率为91.1%。大多数患者接受2- 6mg /天的维持性PER, 107例接受4mg /天PER的患者的SFR最高(89.7%)。在入组前3个月内有2次癫痫发作的患者在13-26周无癫痫发作的可能性明显低于≤2次癫痫发作的患者。79例(38.9%)患者发生与治疗相关的teae,其中大多数是轻度和可耐受的。2例(1.0%)患者因teae退出研究。最常见的症状是头晕、易怒、嗜睡和疲劳。结论:PER作为初始单药治疗在中国4-12岁新诊断的FOS患者中是有效且耐受的。在我们的研究中没有出现安全问题。
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来源期刊
World Journal of Pediatrics
World Journal of Pediatrics 医学-小儿科
CiteScore
10.50
自引率
1.10%
发文量
592
审稿时长
2.5 months
期刊介绍: The World Journal of Pediatrics, a monthly publication, is dedicated to disseminating peer-reviewed original papers, reviews, and special reports focusing on clinical practice and research in pediatrics. We welcome contributions from pediatricians worldwide on new developments across all areas of pediatrics, including pediatric surgery, preventive healthcare, pharmacology, stomatology, and biomedicine. The journal also covers basic sciences and experimental work, serving as a comprehensive academic platform for the international exchange of medical findings.
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