Abstract：
OBJECTIVE: We aimed to identify factors that contribute to the discontinuation of perampanel.
METHODS: We retrospectively analyzed patients with epilepsy at the Department of Psychiatry, Hokkaido University Hospital. We evaluated the factors contributing to perampanel discontinuation as primary outcomes using Cox proportional hazards regression. Then, we explored the components contributing to the primary outcomes using logistic regression analysis.
RESULTS: A total of 118 patients were included, 44.9% of whom discontinued participation, 22.0% had intellectual disability, and 23.7% had a psychiatric disorder other than intellectual disability. Adverse effects occurred in 65% of the patients, 23.7% had psychiatric adverse effects (PAE), and 49.2% had common adverse effects (CAE). The effect of PER to suppress seizures was confirmed in 65.3% of them. Discontinuation was influenced by non-response (Hazard Ratio (HR) 6.70, 95% Confidence Interval (CI) 3.42-13.1), the occurrence of PAE (HR 3.68, 95% CI 1.89-7.16), CAE (HR 1.90, 95% CI 1.06-3.41), and comorbid psychiatric disorders (HR 2.35, 95% CI 1.21-4.59). Moreover, comorbid intellectual disability correlated with a low risk of PAE (OR 0.19, 95% CI 0.04-0.89).
CONCLUSIONS: The discontinuation of perampanel is influenced by poor efficacy and the occurrence of common/psychiatric adverse effects. The discontinuation of perampanel is influenced by poor efficacy and the occurrence of common/psychiatric adverse effects. Consideration of factors contributing to perampanel discontinuation may assist in determining the indication for perampanel treatment.
METHODS: We retrospectively analyzed patients with epilepsy at the Department of Psychiatry, Hokkaido University Hospital. We evaluated the factors contributing to perampanel discontinuation as primary outcomes using Cox proportional hazards regression. Then, we explored the components contributing to the primary outcomes using logistic regression analysis.
RESULTS: A total of 118 patients were included, 44.9% of whom discontinued participation, 22.0% had intellectual disability, and 23.7% had a psychiatric disorder other than intellectual disability. Adverse effects occurred in 65% of the patients, 23.7% had psychiatric adverse effects (PAE), and 49.2% had common adverse effects (CAE). The effect of PER to suppress seizures was confirmed in 65.3% of them. Discontinuation was influenced by non-response (Hazard Ratio (HR) 6.70, 95% Confidence Interval (CI) 3.42-13.1), the occurrence of PAE (HR 3.68, 95% CI 1.89-7.16), CAE (HR 1.90, 95% CI 1.06-3.41), and comorbid psychiatric disorders (HR 2.35, 95% CI 1.21-4.59). Moreover, comorbid intellectual disability correlated with a low risk of PAE (OR 0.19, 95% CI 0.04-0.89).
CONCLUSIONS: The discontinuation of perampanel is influenced by poor efficacy and the occurrence of common/psychiatric adverse effects. The discontinuation of perampanel is influenced by poor efficacy and the occurrence of common/psychiatric adverse effects. Consideration of factors contributing to perampanel discontinuation may assist in determining the indication for perampanel treatment.
摘要：
目的：我们的目的是确定导致停药的因素。
方法：我们回顾性分析了精神科的癫痫患者，北海道大学医院。我们使用Cox比例风险回归评估了导致Perampanel停药的主要结局因素。然后，我们使用logistic回归分析探讨了主要结局的影响因素.
结果：共纳入118例患者，44.9%的人停止参与，22.0%有智力残疾，23.7%患有智力残疾以外的精神疾病。65％的患者出现不良反应，23.7%有精神病不良反应(PAE)，49.2%有常见不良反应(CAE)。其中65.3%证实了PER抑制癫痫发作的效果。停药受无反应影响（危险比（HR）6.70，95％置信区间（CI）3.42-13.1），PAE的发生（HR3.68，95%CI1.89-7.16），CAE（HR1.90，95%CI1.06-3.41），和精神疾病合并症（HR2.35，95%CI1.21-4.59）。此外，共患智力障碍与PAE的低风险相关(OR0.19，95%CI0.04-0.89)。
结论：停药受疗效差和常见/精神不良反应发生的影响。停药perampanel受疗效差和常见/精神病不良反应发生的影响。考虑导致Perampanel停药的因素可能有助于确定Perampanel治疗的适应症。
方法：我们回顾性分析了精神科的癫痫患者，北海道大学医院。我们使用Cox比例风险回归评估了导致Perampanel停药的主要结局因素。然后，我们使用logistic回归分析探讨了主要结局的影响因素.
结果：共纳入118例患者，44.9%的人停止参与，22.0%有智力残疾，23.7%患有智力残疾以外的精神疾病。65％的患者出现不良反应，23.7%有精神病不良反应(PAE)，49.2%有常见不良反应(CAE)。其中65.3%证实了PER抑制癫痫发作的效果。停药受无反应影响（危险比（HR）6.70，95％置信区间（CI）3.42-13.1），PAE的发生（HR3.68，95%CI1.89-7.16），CAE（HR1.90，95%CI1.06-3.41），和精神疾病合并症（HR2.35，95%CI1.21-4.59）。此外，共患智力障碍与PAE的低风险相关(OR0.19，95%CI0.04-0.89)。
结论：停药受疗效差和常见/精神不良反应发生的影响。停药perampanel受疗效差和常见/精神病不良反应发生的影响。考虑导致Perampanel停药的因素可能有助于确定Perampanel治疗的适应症。
