Perampanel Monotherapy Promotes Seizure Freedom, Intranasal Midazolam Rapidly Effective, Safe Alternative in Status Epilepticus, Sleep Disorders and Epilepsy

This week, Neurology News Network covered preliminary data showing that perampanel is safe, effective, and well-tolerated as monotherapy in previously untreated patients with partial-onset seizures or primary generalized tonic-clonic seizures, findings demonstrating intranasal midazolam's safety and effectiveness as an alternative first-line therapy for status epilepticus, and a group of studies confirming that children with epilepsy, particularly those with refractory disease, experience higher rates of sleep disorders than those without (transcript below).

Jenna:

Welcome to Neurology News Network. I’m Jenna Payesko. Let’s get into the news from this week.

Preliminary data presented at the 2019 International Epilepsy Congress in Bangkok, Thailand, shows that Eisai’s perampanel, marketed as Fycompa, is safe, effective, and well-tolerated as monotherapy in previously untreated patients with partial-onset seizures or primary generalized tonic-clonic seizures.

Perampanel is currently being evaluated in a phase 3, multi-center, open-label, uncontrolled study known as FREEDOM, in patients age 12 and older with partial-onset seizures with or without secondary generalized seizures. The ongoing study, which includes patients from Japan and South Korea, consists of a 6-week titration period followed by a 26-week, 4 mg per day maintenance period. If a patient experiences seizures during the maintenance period, they are titrated up to 8 mg per day perampanel, followed by a 26-week maintenance period. Among those included in the 4 mg intent to treat population, 63% achieved seizure freedom, and 65% of those with secondarily generalized seizures were convulsive seizure free. Treatment-emergent adverse events were reported in 78.7% of patients, with the most common being dizziness, somnolence, nasopharyngitis, and headache, all of which are consistent with the drug’s known safety profile.

Intranasal midazolam is both safe and rapidly effective as an alternative first-line therapy for status epilepticus, according to findings presented at the 2019 International Epilepsy Congress.

More than 57% of patients who received intranasal midazolam were responders, with status epilepticus ceasing within an average of 5 minutes and 5 seconds. Based on the findings, Dr. Lara Kay and colleagues concluded that intranasal administration of midazolam appears to be an easily applicable and rapidly effective alternative to buccal and intramuscular application as first line treatment if an intravenous route is not available.

A group of studies help confirm what previous literature has described—that children with epilepsy, particularly those with refractory disease, experience higher rates of sleep disorders than those without, and that these comorbidities are damaging to patients’ quality of life and social adjustment. A trio of unrelated studies showed high rates of sleep disorders in patients with epilepsy, and all suggested that these comorbidities may be underestimated and under-evaluated. All 3 studies were presented as posters at the 2019 International Epilepsy Congress.

For more coverage of IEC 2019 and other neurology news, head to neurologylive.com. This has been Neurology News Network. Thanks for watching.