■FAME(Fycompa®作为癫痫患者单一疗法的第一个附加方案;NCT02726074),以前报道的单臂,第四阶段研究,显示,在85名年龄≥12岁的韩国患者中,有或没有双侧强直阵挛性癫痫发作(FOS)的局灶性发作性癫痫发作(FOS)患者中,Perampanel作为失败的抗癫痫药物(ASM)单药治疗的第一个附加药物改善了癫痫发作控制。我们提供了FAME的三项事后分析结果,这些分析进一步评估了perampanel的疗效和安全性。
■患者按低剂量(4、6mg/天)和高剂量(8、10、12mg/天)维持剂量进行分层,Perampanel添加到一线与二线ASM单药治疗中,以及伴随的背景ASM单一疗法和perampanel剂量。主要终点是24周维持期内总发作频率降低≥50%的患者比例。通过治疗引起的不良事件(TEAE)的描述性发生率评估安全性。
■在事后分析中,50%的应答率明显高于低剂量和高剂量的perampanel(88.6%与40.0%;p<0.001),当加入一线与二线ASM单药治疗时(83.5%与33.3%;p=0.013)。通过伴随的背景ASM和perampanel维持剂量,50%的应答率是100%的帕拉尼4毫克/天添加到卡马西平,奥卡西平,拉莫三嗪,或者丙戊酸,和85%时加入到左乙拉西坦中。附加的perampanel提高了75%,无癫痫发作的应答率,和每28天相对于基线癫痫发作频率的中位数百分比变化。当加入ASM单药治疗时,Perampanel的耐受性良好,头晕是最常见的TEAE。
■对FAME的事后分析为使用perampanel作为FOS患者广泛的ASM单一疗法的有效且耐受性良好的首次附加治疗提供了支持性数据。
UNASSIGNED: FAME (Fycompa® as first Add-on to Monotherapy in patients with Epilepsy; NCT02726074), a previously reported single-arm, phase IV study, showed that perampanel improved seizure control as first add-on to failed anti-seizure medication (ASM) monotherapy in 85 South Korean patients aged ≥12 years with focal-onset seizures (FOS) with/without focal to bilateral tonic-clonic seizures. We present results of three post hoc analyses of FAME that further assessed the efficacy and safety of perampanel.
UNASSIGNED: Patients were stratified by low- (4, 6 mg/day) versus high- (8, 10, 12 mg/day) dose maintenance perampanel, perampanel added to first- versus second-line ASM monotherapy, and concomitant background ASM monotherapy and perampanel dose. The primary endpoint was the proportion of patients with a ≥50% reduction in total seizure frequency during the 24-week maintenance period. Safety was assessed by the descriptive incidence of treatment-emergent adverse events (TEAEs).
UNASSIGNED: In post hoc analyses, 50% responder rates were significantly higher for low- versus high-dose maintenance perampanel (88.6% vs. 40.0%; p<0.001) and when added to first- versus second-line ASM monotherapy (83.5% vs. 33.3%; p=0.013). By concomitant background ASM and perampanel maintenance dose, 50% responder rates were 100% for perampanel 4 mg/day added to carbamazepine, oxcarbazepine, lamotrigine, or valproic acid, and 85% when added to levetiracetam. Add-on perampanel improved 75% and seizure-free responder rates, and median percent changes from baseline seizure frequency per 28 days. Perampanel was well tolerated when added to ASM monotherapy, with dizziness being the most common TEAE.
UNASSIGNED: Post hoc analyses of FAME provide supportive data for the use of perampanel as an effective and well-tolerated first add-on treatment to a broad spectrum of ASM monotherapies in patients with FOS.