吡仑帕奈治疗特发性震颤的震颤解消作用无持续性：50例患者的真实世界经验
Non-Persistence of Tremorolytic Effect of Perampanel in Essential Tremor: Real-World Experience with 50 Patients.
作者信息
Gironell Alexandre, Pascual-Sedano Berta, Marín-Lahoz Juan, Pérez Jesús, Pagonabarraga Javier
机构信息
Movement Disorders Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau Autonomous University of Barcelona Barcelona Catalonia Spain.
Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED) Spain.
出版信息
Mov Disord Clin Pract. 2022 Oct 13;10(1):74-78. doi: 10.1002/mdc3.13576. eCollection 2023 Jan.
BACKGROUND
We describe our experience of using perampanel to treat essential tremor (ET) over 12 months.
METHODS
We enrolled 50 ET patients in an open-label trial. Perampanel was titrated to 4 mg/day as adjuvant therapy. The main outcome measures were baseline, +1, +3, +6, and + 12 month scores of the Tremor Clinical Rating Scale (TCRS) and the Glass scale (GS).
RESULTS
Twenty patients withdrew because of adverse effects. At +1 month, 27 of 30 patients improved: 68% reduction in both TCRS 1 + 2 ( < 0.001) and TCRS 3 ( < 0.001); TCRS 4 + 1.8 and GS 1.1 point reduction. By +12 months non-persistence of therapeutic effect occurred in 70% of patients: the mean reduction in TCRS 1 + 2 was 33% ( = 0.03), TCRS 3 (0.04), TCRS 4 + 0.8, GS 0.2 points reduction.
CONCLUSIONS
We report important peramapanel acute tremorolytic effects, but poor tolerance to adverse effects and a non-sustained therapeutic effect in most patients.
背景
我们描述了使用吡仑帕奈治疗特发性震颤（ET）超过12个月的经验。
方法
我们招募了50名ET患者进行开放标签试验。吡仑帕奈作为辅助治疗滴定至4毫克/天。主要结局指标是震颤临床评定量表（TCRS）和格拉斯量表（GS）的基线、+1、+3、+6和+12个月评分。
结果
20名患者因不良反应退出。在+1个月时，30名患者中的27名病情改善：TCRS 1+2（<0.001）和TCRS 3（<0.001）均降低68%；TCRS 4降低1.8，GS降低1.1分。到+12个月时，70%的患者出现治疗效果不持久的情况：TCRS 1+2的平均降低率为33%（P=0.03），TCRS 3（P=0.04），TCRS 4降低0.8，GS降低0.2分。
结论
我们报告了吡仑帕奈重要的急性震颤缓解作用，但大多数患者对不良反应耐受性差且治疗效果不持久。
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