Abstract：
BACKGROUND: Post-stroke epilepsy (PSE) is one of the most common causes of acquired epilepsy. Nevertheless, there is limited evidence regarding the clinical profile of antiseizure medications (ASMs) in PSE. This study aims to evaluate the 12-month effectiveness and tolerability of perampanel (PER) used as only add-on treatment in patients with PSE in a real-world setting.
METHODS: We performed a subgroup analysis of PSE patients included in a previous retrospective, longitudinal, multicentre observational study on adults. Treatment discontinuation, seizure frequency and adverse events were collected at 3, 6 and 12 months. Sub-analyses by early (≤1 previous ASM) or late PER add-on were also conducted.
RESULTS: Our analysis included 56 individuals with PSE, characterized by varying initial treatment modalities and timeframes relative to disease onset. We found notable retention rates (92.8%, 83.7%, and 69% at 3, 6, and 12 months), with treatment withdrawal mainly due to poor tolerability. One year after PER introduction, seizure frequency significantly reduced, with a responder rate (≥50% reduction) of 83.9% and a seizure-free rate of 51.6%. Adverse events occurred in 25 (46.3%) patients, mainly dizziness, irritability, and behavioural disorders. No major statistical differences were found between early (30 patients, 53.6%) and late add-on groups, except for a higher 6-month responder rate in the early add-on group.
CONCLUSIONS: Adjunctive PER was effective and well-tolerated in patients with PSE in a real-world setting. Perampanel demonstrated good efficacy and safety as both early and late add-on treatment, making it a compelling option for this unique patient population.
METHODS: We performed a subgroup analysis of PSE patients included in a previous retrospective, longitudinal, multicentre observational study on adults. Treatment discontinuation, seizure frequency and adverse events were collected at 3, 6 and 12 months. Sub-analyses by early (≤1 previous ASM) or late PER add-on were also conducted.
RESULTS: Our analysis included 56 individuals with PSE, characterized by varying initial treatment modalities and timeframes relative to disease onset. We found notable retention rates (92.8%, 83.7%, and 69% at 3, 6, and 12 months), with treatment withdrawal mainly due to poor tolerability. One year after PER introduction, seizure frequency significantly reduced, with a responder rate (≥50% reduction) of 83.9% and a seizure-free rate of 51.6%. Adverse events occurred in 25 (46.3%) patients, mainly dizziness, irritability, and behavioural disorders. No major statistical differences were found between early (30 patients, 53.6%) and late add-on groups, except for a higher 6-month responder rate in the early add-on group.
CONCLUSIONS: Adjunctive PER was effective and well-tolerated in patients with PSE in a real-world setting. Perampanel demonstrated good efficacy and safety as both early and late add-on treatment, making it a compelling option for this unique patient population.
摘要：
背景：卒中后癫痫（PSE）是获得性癫痫的最常见原因之一。然而，关于PSE中抗癫痫药物(ASM)的临床特征的证据有限.这项研究旨在评估在现实世界中PSE患者仅用作附加治疗的perampanel（PER）的12个月有效性和耐受性。
方法：我们对以前的回顾性研究中纳入的PSE患者进行了亚组分析，纵向,成人多中心观察性研究。停止治疗,收集3,6和12个月时的癫痫发作频率和不良事件.还进行了早期(≤1个先前的ASM)或晚期PER附加子分析。
结果：我们的分析包括56名PSE患者，以相对于疾病发作的不同初始治疗方式和时间框架为特征。我们发现显著的保留率(92.8%，83.7%,在3、6和12个月时为69%)，治疗退出主要是由于耐受性差。PER引入一年后，癫痫发作频率显著降低，应答率（减少≥50％）为83.9％，无癫痫发作率为51.6％。25例（46.3%）患者发生不良事件，主要是头晕,烦躁，和行为障碍。早期(30例患者，53.6%)和后期附加组，除了早期添加组的6个月应答率更高。
结论：在真实世界环境中，辅助PER在PSE患者中是有效且耐受性良好的。Perampanel在早期和晚期附加治疗中表现出良好的疗效和安全性，使其成为这个独特的患者群体的一个令人信服的选择。
方法：我们对以前的回顾性研究中纳入的PSE患者进行了亚组分析，纵向,成人多中心观察性研究。停止治疗,收集3,6和12个月时的癫痫发作频率和不良事件.还进行了早期(≤1个先前的ASM)或晚期PER附加子分析。
结果：我们的分析包括56名PSE患者，以相对于疾病发作的不同初始治疗方式和时间框架为特征。我们发现显著的保留率(92.8%，83.7%,在3、6和12个月时为69%)，治疗退出主要是由于耐受性差。PER引入一年后，癫痫发作频率显著降低，应答率（减少≥50％）为83.9％，无癫痫发作率为51.6％。25例（46.3%）患者发生不良事件，主要是头晕,烦躁，和行为障碍。早期(30例患者，53.6%)和后期附加组，除了早期添加组的6个月应答率更高。
结论：在真实世界环境中，辅助PER在PSE患者中是有效且耐受性良好的。Perampanel在早期和晚期附加治疗中表现出良好的疗效和安全性，使其成为这个独特的患者群体的一个令人信服的选择。
