目的 评估吡仑帕奈添加治疗≥12岁局灶性癫痫患者的有效性、耐受性及安全性。 方法 回顾性选择自2020年7月至2022年12月于广西医科大学第一附属医院神经内科接受吡仑帕奈添加治疗的119例≥12岁青少年及成人局灶性癫痫患者为研究对象，分别采集添加治疗第1~3个月、4~6个月、7~9个月和10~12个月阶段中患者每28天的癫痫发作频率、坚持用药情况及不良反应发生情况等，以评估吡仑帕奈添加治疗的有效性（癫痫发作频率较基线减少≥50%为总有效）、耐受性及安全性，同时依据吡仑帕奈添加治疗第4~6个月（短期）和10~12个月（长期）的有效性结果，将患者分为有效组与无效组，分析影响吡仑帕奈添加治疗短期及长期有效性的相关因素。 结果 吡仑帕奈添加治疗第1~3个月、4~6个月、7~9个月、10~12个月阶段中，患者每28天的癫痫发作频率较基线降低百分比分别为66。7%（24。3%，97。2%）、77。5%（48。6%，100。0%）、94。6%（50。0%，100。0%）、100。0%（70。9%，100。0%），总有效率分别为60。2%（59/98）、75。0%（57/76）、78。9%（45/57）、86。5%（32/37）。吡仑帕奈添加治疗第3、6、9和12个月末时，患者保留率分别为85。2%（98/115）、67。9%（76/112）、54。3%（57/105）、41。1%（37/90）。吡仑帕奈添加治疗期间，共有33例（27。7%）患者出现不良反应，主要症状为头晕，其次为精神症状。吡仑帕奈添加治疗第4~6个月和10~12个月阶段中，有效组与无效组患者间性别、添加吡仑帕奈治疗初始年龄、病程、病因、脑电图检查结果、影像学检查结果、联合抗癫痫发作药物的数量及种类、吡仑帕奈最大服用剂量等方面的差异均无统计学意义（P>0。05）。 结论 吡仑帕奈添加治疗≥12岁青少年及成人局灶性癫痫具有良好的有效性、耐受性及安全性。目前尚未发现影响吡仑帕奈添加治疗有效性的相关因素。 Objective To evaluate the clinical efficacy， tolerability and safety of adjunctive perampanel in focal epilepsy patients≥12 years old。 Methods One hundred and nineteen focal epilepsy patients≥12 years old accepted adjunctive perampanel in Department of Neurology， First Affiliated Hospital of Guangxi Medical University from July 2020 to December 2022 were chosen。 At 1-3 months， 4-6 months， 7-9 months and 10-12 months after adjunctive perampanel， seizure frequency changes every 28 d， medication retention rate and adverse reactions were recorded to evaluate the clinical efficacy (a reduction in seizure frequency≥50% from baseline was defined as overall valid treatment)， tolerability and safety of adjunctive perampanel。 According to efficacy results after adjunctive perampanel of 4-6 months (short-term) and 10-12 months (long-term)， these patients were divided into valid group and invalid group and the influencing factors for short-term and long-term efficacy were analyzed。 Results At 1-3， 4-6， 7-9， 10-12 months after adjunctive perampanel， reduction in seizure frequency every 28 d was 66。7% (24。3%， 97。2%)， 77。5% (48。6%， 100%)， 94。6% (50%， 100%)， 100% (70。9%， 100%)， enjoying overall valid rate of 60。2% (59/98)， 75。0% (7/76)， 78。9% (45/57)， 86。5% (32/37)。 The retention rate at 3， 6， 9 and 12 months after adjunctive perampanel was 85。2% (98/115)， 67。9% (76/112)， 54。3% (57/105)， 41。1% (37/90)。 Adverse reactions were reported in 33 patents (27。7%)， mainly with dizziness and secondly with mental symptoms。 After short-term and long-term adjunctive perampanel， no significant difference was noted in gender， initial age of adjunctive perampanel， course of disease， etiology， EEG results， imaging results， number and type of combined anti-seizure drugs， or maximum dose of pirampanel between the valid group and invalid group (P>0。05)。 Conclusion Perampanel has good efficacy， tolerability and safety in adolescents and adults≥12 years old with focal epilepsy no clear influencing factors for pirampanel valid treatment is found so far。
Clinical efficacy of adjunctive perampanel in focal epilepsy patients≥12 years old
Objective To evaluate the clinical efficacy, tolerability and safety of adjunctive perampanel in focal epilepsy patients≥12 years old. Methods One hundred and nineteen focal epilepsy patients≥12 years old accepted adjunctive perampanel in Department of Neurology, First Affiliated Hospital of Guangxi Medical University from July 2020 to December 2022 were chosen. At 1-3 months, 4-6 months, 7-9 months and 10-12 months after adjunctive perampanel, seizure frequency changes every 28 d, medication retention rate and adverse reactions were recorded to evaluate the clinical efficacy (a reduction in seizure frequency≥50% from baseline was defined as overall valid treatment), tolerability and safety of adjunctive perampanel. According to efficacy results after adjunctive perampanel of 4-6 months (short-term) and 10-12 months (long-term), these patients were divided into valid group and invalid group and the influencing factors for short-term and long-term efficacy were analyzed. Results At 1-3, 4-6, 7-9, 10-12 months after adjunctive perampanel, reduction in seizure frequency every 28 d was 66.7% (24.3%, 97.2%), 77.5% (48.6%, 100%), 94.6% (50%, 100%), 100% (70.9%, 100%), enjoying overall valid rate of 60.2% (59/98), 75.0% (7/76), 78.9% (45/57), 86.5% (32/37). The retention rate at 3, 6, 9 and 12 months after adjunctive perampanel was 85.2% (98/115), 67.9% (76/112), 54.3% (57/105), 41.1% (37/90). Adverse reactions were reported in 33 patents (27.7%), mainly with dizziness and secondly with mental symptoms. After short-term and long-term adjunctive perampanel, no significant difference was noted in gender, initial age of adjunctive perampanel, course of disease, etiology, EEG results, imaging results, number and type of combined anti-seizure drugs, or maximum dose of pirampanel between the valid group and invalid group (P>0.05). Conclusion Perampanel has good efficacy, tolerability and safety in adolescents and adults≥12 years old with focal epilepsy no clear influencing factors for pirampanel valid treatment is found so far.
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