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Perampanel

(Fycompa®)

Perampanel

Drug updated on 4/15/2024

Dosage FormTablet (oral; 2 mg, 4 mg, 6 mg, 8 mg, 10 mg, and 12 mg); suspension (oral; 0.5 mg/mL)
Drug ClassNon-competitive AMPA glutamate receptor antagonists
Ongoing and
Completed Studies		ClinicalTrials.gov

Indication

  • Indicated for treatment of partial-onset seizures with or without secondarily generalized seizures in patients with epilepsy 4 years of age and older.
  • Indicated for adjunctive therapy in the treatment of primary generalized tonic-clonic seizures in patients with epilepsy 12 years of age and older.

Summary
This AI-generated content is provided without warranty and may be inaccurate or outdated; it should be used only as a research starting point, with no liability accepted for reliance on it. Learn more.

  • Perampanel (Fycompa) is indicated for the treatment of partial-onset seizures with or without secondarily generalized seizures in patients with epilepsy aged 4 years and older, and as adjunctive therapy in treating primary generalized tonic-clonic seizures in patients aged 12 years and above.
  • Eighteen studies were reviewed to gather information about this medication's safety and effectiveness compared to other antiseizure medications.
  • Compared to Lacosamide (LCM) and Levetiracetam (LEV), perampanel's risk for arrhythmias was not thoroughly investigated due to insufficient data.
  • In controlling refractory epilepsy, perampanel showed a significant ability to reduce seizure frequency better than a placebo. However, Brivaracetam (BRV) demonstrated the best tolerability among these options.
  • As an add-on therapy for drug-resistant focal epilepsy, perampanel significantly increased the chances of a reduction by at least half in seizure frequency but had a higher likelihood of treatment discontinuation due to adverse effects compared with a placebo.
  • For idiopathic generalized epilepsies (IGEs), while valproate and ethosuximide ranked top for efficacy on specific types of IGEs, perampanel exhibited superior tolerability measured by any treatment-emergent adverse event.
  • Studies focused on children and adolescents showed meaningful efficacy from using Fycompa; however, some discontinuation occurred due to its side effects, indicating the need for careful consideration in younger demographics.
  • In patients suffering from brain tumor-related epilepsy (BTRE), perampanel has shown promising results regarding controlling seizures along with an acceptable safety profile.

Product Monograph / Prescribing Information

Document TitleYearSource
Fycompa (perampanel) Prescribing Information.2021Eisai Inc., Nutley, NJ

Systematic Reviews / Meta-Analyses

Document TitleYearSource
Risk assessment of arrhythmias related to three antiseizure medications: a systematic review and single-arm meta-analysis.2024Frontiers in Neurology
The efficacy and safety of third-generation antiseizure medications and non-invasive brain stimulation to treat refractory epilepsy: a systematic review and network meta-analysis study.2024Frontiers in Neurology
Antiseizure medications for idiopathic generalized epilepsies: a systematic review and network meta-analysis.2023Journal of Neurology
Perampanel add‐on for drug‐resistant focal epilepsy.2023Cochrane Database of Systematic Reviews
Efficacy and tolerability of perampanel in patients with seizures in real-world clinical practice: a systematic review and meta-analysis.2023Frontiers in Pharmacology
Efficacy and tolerability of perampanel in brain tumor-related epilepsy: a systematic review.2023Biomedicines
Efficacy, tolerability and safety of perampanel in children and adolescents with epilepsy: systematic review and meta-analysis.2023Brain & Development
Perampanel in brain tumor-related epilepsy: a systematic review.2023Brain Sciences
The safety of perampanel in different disorders and doses: a meta-analysis.2023Seizure: European Journal of Epilepsy
Efficacy and safety of perampanel for epilepsy: a systematic review and meta-analysis of real-world studies. 2023European Review for Medical and Pharmacological Sciences
The efficacy and safety of adjunctive perampanel for the treatment of refractory focal-onset seizures in patients with epilepsy: a meta-analysis. 2022Epilepsia Open
Movement disorders secondary to novel antiseizure medications in pediatric populations: a systematic review and meta-analysis of risk.2022Journal of Child Neurology
Third‑generation antiseizure medications for adjunctive treatment of focal‑onset seizures in adults: a systematic review and network meta‑analysis.2022Drugs
Perampanel in achieving status epilepticus cessation: a systematic review. 2022Epilepsy & Behavior
Perampanel monotherapy for the treatment of epilepsy: Clinical trial and real-world evidence2022Epilepsy & Behavior
Exploring the evidence for broad‑spectrum effectiveness of perampanel: a systematic review of clinical data in generalised seizures.2021CNS Drugs
Behavioral adverse events with brivaracetam, levetiracetam, perampanel, and topiramate: a systematic review.2021Epilepsy & Behavior
A systematic review and indirect treatment comparison of perampanel versus brivaracetam as adjunctive therapy in patients with focal-onset seizures with or without secondary generalization.2020Epilepsy Research

Clinical Practice Guidelines

Document TitleYearSource
Perampanel.2023Epilepsy Foundation
Perampanel as first add-on antiseizure medication: Italian consensus clinical practice statements.2021BMC Neurology
Clinical practice guidelines for the management of epilepsy in adults and children. 2020Ontario Brain Institute