吡仑帕奈治疗成人癫痫的临床实践

Perampanel as therapy for adult epilepsy patients treated in clinical practice

目的评估吡仑帕奈治疗中国成人癫痫患者的临床疗效及安全耐受性。方法回顾性分析2020年1月—2022年12月就诊于吉林大学中日联谊医院神经内科并使用吡仑帕奈治疗的成人癫痫患者的临床资料,包括患者人口学、临床特征以及吡仑帕奈治疗前后患者的癫痫发作变化和吡仑帕奈治疗过程中出现的不良事件等,评估吡仑帕奈用于中国成人癫痫患者的临床疗效与安全性。结果共纳入69例具有完整随访资料的使用吡仑帕奈治疗的成人癫痫患者,吡仑帕奈治疗剂量范围为2~8 mg,总有效率为68.1%,癫痫无发作率为17.4%。吡仑帕奈治疗过程中最常见的不良反应为情绪改变与头晕,不良反应发生率为52.2%,严重不良反应发生率为0.0%。疗效影响因素分析:单药治疗或联合治疗、合并抗癫痫发作药物类型及吡仑帕奈添加治疗时间均不会影响其疗效(P>0.05),而剂量为影响吡仑帕奈疗效的重要因素(P<0.05),且局灶性癫痫组与全面性癫痫组疗效无显著性差异(P>0.05)。不良事件发生相关因素分析:不良反应发生与吡仑帕奈使用剂量相关(P<0.05),与是否单药治疗、吡仑帕奈添加时间及合并抗癫痫药类型无关(P>0.05)。结论吡仑帕奈在中国成人癫痫治疗中,有着良好的疗效与安全耐受性。无论单药治疗还是添加治疗都可以有效控制癫痫发作,且对不同发作类型癫痫均有着良好疗效。吡仑帕奈治疗过程中最常见的不良事件为情绪改变和头晕,但随着治疗时间延长大部分可减轻并耐受。

Objective To evaluate the clinical efficacy and safety tolerance of perampanel in the treatment of Chinese adult epilepsy patients.Methods Clinical data of adult epileptic patients treated with perampanel in Department of Neurology,China-Japan Union Hospital of Jilin University from January 2020 to December 2022 were analyzed retrospectively by self-control method,including demographic and clinical characteristics of patients,changes of epileptic seizures before and after perampanel treatment and adverse events during the treatment of perampanel.To evaluate the clinical efficacy and safety of perampanel in Chinese adult epileptic patients.Results A total of 69 adult epileptic patients with complete follow-up data were included.The dosage range of perampanel was 2~8 mg.The total effective rate was 68.1%,and the seizure-free rate was 17.4%.The most common adverse reactions were mood change and dizziness,the incidence of adverse reactions was 52.2%,and the incidence of serious adverse reactions was 0.0%.In terms of analysis of influencing factors of efficacy,the results showed that single drug therapy or combination therapy,type of combined antiepileptic drug and treatment time of perampanel did not affect the efficacy(P>0.05),while dosage was an important factor affecting the efficacy of perampanel(P<0.05),and there was no significant difference in efficacy between the focal epilepsy group and the general epilepsy group(P>0.05).In terms of the analysis of factors related to the occurrence of adverse reactions,the results showed that the occurrence of adverse reactions was related to the dosage of perampanel(P<0.05),and was independent of whether it was monotherapy,the addition time of perampanel and the type of combined antiepileptic agents(P>0.05).Conclusion Perampanel has good efficacy and safety tolerance in the treatment of epilepsy in Chinese adults.Both monotherapy and additive therapy can effectively control seizures,and has a good effect on different seizure types.The most common adverse events during treatment were mood changes and dizziness,which could be alleviated and tolerated by most patients with prolonged treatment.