Kerling F, Kasper B S
Department of Neurology, University of Ulm, Ulm, Germany.
Acta Neurol Scand Suppl. 2013(197):25-9. doi: 10.1111/ane.12101.
The efficacy of adjunctive perampanel has been investigated in an extensive clinical development program across a broad, multinational population of patients with refractory partial-onset seizures. Further to the results of two Phase II dose-finding studies, perampanel was evaluated in three large Phase III registration studies at the predicted no-effect dose of 2 mg/day and the predicted effective doses of 4, 8, and 12 mg/day. In all three studies, perampanel 4, 8, and 12 mg/day consistently provided significant reductions in the frequency of partial-onset seizures compared with placebo. Improvements in responder rates and seizure freedom rates were also observed. In addition, data from recent interim analyses of extension studies have indicated that these efficacy outcomes may be maintained with long-term treatment. Overall, these studies form a solid evidence base to support the efficacy of adjunctive perampanel in the treatment of refractory partial-onset seizures.
在一项针对广泛的多国难治性部分性发作患者群体的大规模临床开发项目中,已对辅助使用吡仑帕奈的疗效进行了研究。继两项II期剂量探索研究的结果之后,在三项大型III期注册研究中对吡仑帕奈进行了评估,剂量分别为预测无效剂量2毫克/天以及预测有效剂量4毫克/天、8毫克/天和12毫克/天。在所有三项研究中,与安慰剂相比,每天服用4毫克、8毫克和12毫克的吡仑帕奈持续显著降低了部分性发作的频率。还观察到应答率和无癫痫发作率有所改善。此外,近期扩展研究的中期分析数据表明,长期治疗可能维持这些疗效结果。总体而言,这些研究形成了坚实的证据基础,以支持辅助使用吡仑帕奈治疗难治性部分性发作的疗效。