Liguori Claudio, Izzi Francesca, Manfredi Natalia, D'Elia Alessio, Mari Luisa, Mercuri Nicola Biagio, Fabio Placidi
Epilepsy Centre, Neurophysiopathology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.
Epilepsy Centre, Neurophysiopathology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.
Epilepsy Behav. 2018 Mar;80:173-176. doi: 10.1016/j.yebeh.2018.01.001. Epub 2018 Feb 3.
Perampanel (PER) is a third generation antiepileptic drug (AED), recently approved as add-on therapy in both focal and generalized seizures. Levetiracetam (LEV) is a second generation AED, widely used in patients with epilepsy because of its favorable safety and efficacy profiles. Perampanel and LEV treatments have been associated with the occurrence of similar adverse events (AEs) (sleepiness, irritability, depression, anxiety, aggressiveness). The aim of the present retrospective single center study was to verify the efficacy and tolerability of PER and LEV used as first add-on therapy in patients with epilepsy affected by secondarily generalized seizures. We collected data from 15 patients treated with PER and 26 patients treated with LEV and followed at our site with follow-up visits at 3, 6, and 12months. This retrospective study documented the comparable efficacy of PER and LEV as first add-on treatments in patients affected by uncontrolled secondarily generalized seizures. However, more patients withdrawn LEV because of AEs compared with PER at the 3- and 12-month follow-up visits. The better tolerability of PER observed in this study could be related to the low therapeutic dose of PER prescribed when it is used as first adjunctive treatment for better controlling secondarily generalized seizures.
吡仑帕奈（PER）是一种第三代抗癫痫药物（AED），最近被批准用于局灶性和全身性癫痫发作的附加治疗。左乙拉西坦（LEV）是第二代AED，因其良好的安全性和疗效而广泛应用于癫痫患者。吡仑帕奈和左乙拉西坦治疗均与类似不良事件（AEs）（嗜睡、易怒、抑郁、焦虑、攻击性）的发生有关。本回顾性单中心研究的目的是验证吡仑帕奈和左乙拉西坦作为首次附加治疗用于继发全身性癫痫发作患者的疗效和耐受性。我们收集了15例接受吡仑帕奈治疗和26例接受左乙拉西坦治疗的患者的数据，并在我们的研究地点进行随访，随访时间为3个月、6个月和12个月。这项回顾性研究记录了吡仑帕奈和左乙拉西坦作为首次附加治疗用于未得到控制的继发全身性癫痫发作患者时具有相当的疗效。然而，在3个月和12个月的随访中，因不良事件而停用左乙拉西坦的患者比停用吡仑帕奈的患者更多。本研究中观察到的吡仑帕奈更好的耐受性可能与将其用作首次辅助治疗以更好地控制继发全身性癫痫发作时所规定的低治疗剂量有关。
