091 Six years of perampanel: impact on patients with refractory epilepsy

Introduction In 2012 perampanel acquired a UK license for adjunctive therapy in the treatment of epilepsy. It has a mechanism of action distinct from all other anti-epileptic drugs. At Bart’s Health we use it to improve seizure control in patients with refractory (drug-resistant) epilepsy, which affects roughly one third of all patients with epilepsy. Aim To evaluate the contribution of perampanel in the treatment of refractory epilepsy. Methods Electronic patient records were accessed to obtain information on efficacy, adverse effects, maximum tolerated dosage and concomitant medication. Results Permapanel has been used in the treatment of 45 patients. No patients have been rendered seizure-free by the drug. Fifteen patients demonstrated a sustained reduction in seizure frequency and have remained on perampanel therapy. Thirteen patients experienced no, or questionable, benefit and discontinued the drug. Thirteen patients were intolerant and discontinued the drug. There was no clear association with any combination of epilepsy medication. Conclusion Perampanel has enabled us to improve seizure control and quality of life in one third of this cohort of patients, which would have not been possible before its introduction. It has proved a useful addition to the armamentarium of drugs available for the treatment of refractory epilepsy.