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The safety of perampanel in different disorders and doses: A meta-analysis

  • Ping Liu
    Affiliations
    Graduate School of Hebei Medical University, Shijiazhuang, Hebei Province, China

    Department of Pharmacy, Hebei General Hospital, Shijiazhuang, Hebei Province, China
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  • Zhongning Zhu
    Affiliations
    Department of Pharmacology, Hebei Medical University, Shijiazhuang, Hebei Province, China
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  • Huizhen Wu
    Correspondence
    Corresponding Author: Department of Pharmacy, Hebei General Hospital; No. 348, West Heping Road, Shijiazhuang, Hebei Province 050051, China.
    Affiliations
    Graduate School of Hebei Medical University, Shijiazhuang, Hebei Province, China

    Department of Pharmacy, Hebei General Hospital, Shijiazhuang, Hebei Province, China
    Search for articles by this author
Published:January 19, 2023DOI:https://doi.org/10.1016/j.seizure.2023.01.013

      Highlights

      • This report analyzed the safety of perampanel in different disorders and doses with a meta-analysis.
      • Dizziness, ataxia, fatigue, and somnolence showed a clear dose-response relationship.
      • Psychiatric adverse events significantly associated with perampanel occurred more frequently in patients with epilepsy than in other diseases.
      • Dose discontinuation rates due to adverse events were lower in patients with epilepsy patients with epilepsy than in patients with other disorders.

      Abstract

      Purpose

      To investigate the safety of perampanel in different disorders and doses.

      Methods

      Embase, the Cochrane Library, Medline, and ClinicalTrials.gov were searched from inception to July 2022 for randomized controlled trials (RCTs). The meta-analysis was performed by using Review Manager 5.3 and R 4.2.1 software.

      Results

      A total of 17 RCTs with 5711 subjects were included in the final analysis. The double-blind treatment phase was from 12 weeks to 48 weeks. Our results showed that 11 adverse events (aggression, ataxia, balance disorder, dizziness, fall, fatigue, irritability, rash, somnolence, vertigo, and weight increase) were statistically significantly associated with perampanel, and 4 of them (ataxia, dizziness, fatigue, and somnolence) showed a clear dose-response relationship. Psychiatric adverse events occurred most frequently among serious treatment-emergent adverse events (TEAEs). At 8 mg/day, seven adverse events (aggression, balance disorder, dizziness, fatigue, irritability, vertigo, and weight increase) occurred more frequently in patients with epilepsy than in patients with other disorders, whereas dose discontinuation rates due to adverse events were lower in patients with epilepsy than in patients with other disorders.

      Conclusion

      The safety profile of perampanel is dependent on diseases and dose. The risk of adverse events was statistically significantly higher, with doses exceeding 4 mg/day. Despite a higher risk of adverse events, patients with epilepsy had a lower perampanel discontinuation rate than patients with other disorders.

      Keywords

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