佩兰帕奈在临床实践中用于治疗不同病因的癫痫患者:来自 PERMIT 扩展研究的证据。

IF 3.9 3区 医学 Q1 CLINICAL NEUROLOGY Neurology and Therapy Pub Date : 2024-06-01 Epub Date: 2024-04-28 DOI:10.1007/s40120-024-00618-5
Adam Strzelczyk, Marta Maschio, Max C Pensel, Antonietta Coppola, Satoru Takahashi, Shuichi Izumoto, Eugen Trinka, Sheri Cappucci, Ricardo Sainz-Fuertes, Vicente Villanueva
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引用次数: 0

摘要

简介评估抗癫痫药物治疗不同癫痫病因的有效性对于优化个体化治疗方法非常重要。我们利用PERaMpanel疗效和耐受性汇总分析(PERMIT)扩展研究的数据来评估perampanel(PER)在临床实践中用于治疗各种不同病因的癫痫患者时的有效性和安全性/耐受性:对已知病因的患者的 PERMIT 扩展研究数据进行了事后分析。3个月、6个月和12个月后对保留率进行评估。疗效在 3、6 和 12 个月后以及最后一次就诊时进行评估(最后一次观察结转)。疗效评估包括应答率(发作频率减少≥50%)和无发作率(至少自上次就诊以来无发作)。安全性/耐受性通过评估不良事件(AE)和导致停药的AE进行评估:PERMIT 推广项目包括 1945 名结构性病因患者、1012 名遗传性病因患者、93 名感染性病因患者和 26 名免疫性病因患者。12个月的保留率分别为61.1%(结构性)、65.9%(遗传性)、56.8%(感染性)和56.5%(免疫性)。在最后一次就诊时,应答率(癫痫发作总数)分别为43.3%(结构性)、68.3%(遗传性)、37.0%(感染性)和20.0%(免疫性),相应的癫痫无发作率分别为15.8%、46.5%、11.1%和5.0%。AE发生率分别为58.0%(结构性)、46.5%(遗传性)、51.1%(感染性)和65.0%(免疫性),12个月内因AE而停药的相应比率分别为18.9%、16.4%、18.5%和21.7%。不同病因亚组报告的不良反应类型基本一致,没有出现特异性不良反应:尽管在临床实践中,PER 用于治疗各种病因引起的癫痫患者都很有效,而且耐受性普遍良好,但其有效性和耐受性在各亚组间的差异表明,PER 可能对特定病因引起的癫痫患者特别有用。
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Perampanel for Treatment of People with a Range of Epilepsy Aetiologies in Clinical Practice: Evidence from the PERMIT Extension Study.

Introduction: It is important to assess the effectiveness of an antiseizure medication in treating different epilepsy aetiologies to optimise individualised therapeutic approaches. Data from the PERaMpanel pooled analysIs of effecTiveness and tolerability (PERMIT) Extension study were used to assess the effectiveness and safety/tolerability of perampanel (PER) when used to treat individuals with a range of epilepsy aetiologies in clinical practice.

Methods: A post hoc analysis was conducted of PERMIT Extension data from individuals with a known aetiology. Retention was assessed after 3, 6 and 12 months. Effectiveness was assessed after 3, 6 and 12 months and at the last visit (last observation carried forward). Effectiveness assessments included responder rate (≥ 50% seizure frequency reduction) and seizure freedom rate (no seizures since at least the prior visit). Safety/tolerability was assessed by evaluating adverse events (AEs) and AEs leading to discontinuation.

Results: PERMIT Extension included 1945 individuals with structural aetiology, 1012 with genetic aetiology, 93 with an infectious aetiology, and 26 with an immune aetiology. Retention rates at 12 months were 61.1% (structural), 65.9% (genetic), 56.8% (infectious) and 56.5% (immune). At the last visit, responder rates (total seizures) were 43.3% (structural), 68.3% (genetic), 37.0% (infectious) and 20.0% (immune), and corresponding seizure freedom rates were 15.8%, 46.5%, 11.1% and 5.0%, respectively. AE incidence rates were 58.0% (structural), 46.5% (genetic), 51.1% (infectious) and 65.0% (immune), and corresponding rates of discontinuation due to AEs over 12 months were 18.9%, 16.4%, 18.5% and 21.7%, respectively. The types of AEs reported were generally consistent across aetiology subgroups, with no idiosyncratic AEs emerging.

Conclusion: Although PER was effective and generally well tolerated when used to treat individuals with a range of epilepsy aetiologies in clinical practice, variability in its effectiveness and tolerability across the subgroups indicates that PER may be particularly useful for individuals with specific epilepsy aetiologies.

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来源期刊
Neurology and Therapy
Neurology and Therapy CLINICAL NEUROLOGY-
CiteScore
5.40
自引率
8.10%
发文量
103
审稿时长
6 weeks
期刊介绍: Aims and Scope Neurology and Therapy aims to provide reliable and inclusive, rapid publication for all therapy related research for neurological indications, supporting the timely dissemination of research with a global reach, to help advance scientific discovery and support clinical practice. Neurology and Therapy is an international, open access, peer reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world and health outcomes research around the discovery, development, and use of neurological and psychiatric therapies, (also covering surgery and devices). Studies relating to diagnosis, pharmacoeconomics, public health, quality of life, and patient care, management, and education are also welcomed. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, case reports, trial designs, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Neurology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research. Rapid Publication The journal’s rapid publication timelines aim for a peer review decision within 2 weeks of submission. If an article is accepted, it will be published online 3-4 weeks from acceptance. These rapid timelines are achieved through the combination of a dedicated in-house editorial team, who closely manage article workflow, and an extensive Editorial and Advisory Board who assist with rapid peer review. 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