辅助perampanel治疗12岁以下顽固性癫痫的疗效和耐受性。

Korean Journal of Pediatrics Pub Date : 2019-07-01 Epub Date: 2018-12-26 DOI:10.3345/kjp.2018.06863
Yuni Yun, Dongsub Kim, Yun-Jeong Lee, Soonhak Kwon, Su-Kyeong Hwang
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引用次数: 15

摘要

目的:关于12岁以下儿童使用perampanel的数据有限。我们评估了辅助perampanel治疗12岁以下难治性癫痫患儿的疗效和耐受性。方法:回顾性观察研究于2016年7月至2018年3月在庆北大学医院进行。应答者定义为与基线相比,月发作频率降低≥50%的患者。获得不良事件和停药数据以评估耐受性。结果:共纳入22例患者,男8例,女14例,年龄3.1 ~ 11.4岁(平均8.0±2.5岁)。平均随访9.2个月(0.5 ~ 19个月),15例患者(68%)癫痫发作频率降低,其中5例患者(23%)癫痫发作自由。有反应组癫痫发作年龄显著低于无反应组(P=0.048),癫痫持续时间显著长于无反应组(P=0.019)。9例患者(41%)出现不良事件,包括嗜睡(23%)、呼吸抑制(9%)、暴力(4.5%)和癫痫发作加重(4.5%)。最严重的不良事件是呼吸抑制,2例(9%)患者需要机械通气。8名患者(36%)因缺乏疗效或不良事件而停用perampanel。由于不良事件而停用perampanel的4名患者中有3名(75%)有潜在的医疗状况。结论:Perampanel为儿童难治性癫痫提供了一种治疗选择。使用perampanel辅助治疗需要特别考虑那些有潜在医疗条件的患者,以防止严重的不良事件。
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Efficacy and tolerability of adjunctive perampanel treatment in children under 12 years of age with refractory epilepsy.

Purpose: There is limited data on the use of perampanel in children under 12 years of age. We evaluated the efficacy and tolerability of adjunctive perampanel treatment in children under 12 years of age with refractory epilepsy.

Methods: This retrospective observational study was performed in Kyungpook National University Hospital from July 2016 to March 2018. A responder was defined as a patient with ≥50% reduction in monthly seizure frequency compared with the baseline. Adverse events and discontinuation data were obtained to evaluate tolerability.

Results: Twenty-two patients (8 males, 14 females) aged 3.1-11.4 years (mean, 8.0±2.5 years) were included in this study. After an average of 9.2 months (range, 0.5-19 months) of follow-up, 15 patients (68%) showed a reduction in seizure frequency, including 5 patients (23%) with seizure freedom. The age at epilepsy onset was significantly lower (P=0.048), and the duration of epilepsy was significantly longer (P=0.019) in responders than in nonresponders. Nine patients (41%) experienced adverse events, including somnolence (23%), respiratory depression (9%), violence (4.5%), and seizure aggravation (4.5%). The most serious adverse event was respiratory depression, which required mechanical ventilation in 2 patients (9%). Eight patients (36%) discontinued perampanel due to lack of efficacy or adverse events. Three out of 4 patients (75%) who discontinued perampanel due to adverse events had an underlying medical condition.

Conclusion: Perampanel offers a treatment option for refractory epilepsy in children. Adjunctive treatment with perampanel requires special consideration in those with underlying medical conditions to prevent serious adverse events.

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审稿时长
12 weeks
期刊介绍: Korean J Pediatr covers clinical and research works relevant to all aspects of child healthcare. The journal aims to serve pediatricians through the prompt publication of significant advances in any field of pediatrics and to rapidly disseminate recently updated knowledge to the public. Additionally, it will initiate dynamic, international, academic discussions concerning the major topics related to pediatrics. Manuscripts are categorized as review articles, original articles, and case reports. Areas of specific interest include: Growth and development, Neonatology, Pediatric neurology, Pediatric nephrology, Pediatric endocrinology, Pediatric cardiology, Pediatric allergy, Pediatric pulmonology, Pediatric infectious diseases, Pediatric immunology, Pediatric hemato-oncology, Pediatric gastroenterology, Nutrition, Human genetics, Metabolic diseases, Adolescence medicine, General pediatrics.
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