epilepsiaEpilepsy and paroxysmal conditionsЭпилепсия и пароксизмальные состояния2077-83332311-4088IRBIS LLC10.17749/2077-8333.2016.8.4.084-090epilepsia-321Research ArticleORIGINAL ARTICLESОРИГИНАЛЬНЫЕ СТАТЬИPERAMPANEL IN THE TREATMENT OF REFRACTORY EPILEPSY IN EVERYDAY CLINICAL PRACTICE IN ADOLESCENTSПЕРАМПАНЕЛ В ТЕРАПИИ РЕЗИСТЕНТНОЙ ЭПИЛЕПСИИ В ПОВСЕДНЕВНОЙ КЛИНИЧЕСКОЙ ПРАКТИКЕ У ПОДРОСТКОВБурдС. Г.BurdS. G.

д.м.н., профессор кафедры неврологии, нейрохирургии и медицинской генетики лечебного факультета,

ул. Островитянова, д. 1, Москва, 117997

MD, Professor of the department of neurology, neurosurgery and medical genetics, the medical faculty,

ul. Ostrovityanova, 1, Moscow, 117997

burds@yandex.ruМироновМ. Б.MironovM. B.

к.м.н., доцент кафедры клинической физиологии и функциональной диагностики,

Волоколамское шоссе, д. 91, Москва, 125371

PhD, Associate Prof. of the department of clinical physiology and functional diagnostics,

Volokolamskoe s., 91, Moscow 125371

mironovmb@mail.ruГунченкоМ. М.GunchenkoM. M.

заместитель директора по амбулаторно-поликлинической работе,

Мичуринский проспект, д. 74, Москва, 119602

deputy director of the outpatient work,

Michurinsky Prospect, 74, Moscow, 119602

npcdp@zdrav.mos.ruСаржинаМ. Н.SarzhinaM. N.

заведующая отделением медицинской реабилитации

Мичуринский проспект, д. 74, Москва, 119602

head of the department of medical rehabilitation,

Michurinsky Prospect, 74, Moscow, 119602

npcdp@zdrav.mos.ruФГБОУ ВО РНИМУ им. Н.И. Пирогова Минздрава России; Научно-практический центр детской психоневрологии Департамента здравоохранения города МосквыРоссияPirogov Russian NationalResearch Medical University; Scientific and Practical Center of Pediatric psychoneurology Department of HealthRussian FederationФГБОУ ДПО «Институт повышения квалификации Федерального медико-биологического агентства»; Научно-практический центр детской психоневрологии Департамента здравоохранения города МосквыРоссияTraining Institute of the Federal Medical and Biological Agency; Scientific and Practical Center of Pediatric psychoneurology Department of HealthRussian FederationНаучно-практический центр детской психоневрологии Департамента здравоохранения города МосквыРоссияScientific and Practical Center of Pediatric psychoneurology Department of HealthRussian Federation201612032017848490Copyright © Burd S.G., Mironov M.B., Gunchenko M.M., Sarzhina M.N., 20172017Бурд С.Г., Миронов М.Б., Гунченко М.М., Саржина М.Н.Burd S.G., Mironov M.B., Gunchenko M.M., Sarzhina M.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.epilepsia.su/jour/article/view/321

The article presents modern data on the use of perampanel in antiepileptic drug therapy resistant epilepsy in routine clinical practice in adolescents. Despite the well-developed diagnostics and treatment of epilepsy system, about onethird of patients with newly diagnosed disease is resistent to medical therapy. When you select a combination of AEDs for children and adolescents should be borne in mind that school performance can largely predetermine their future. In this regard, the most feared cause such adverse events (AEs) as cognitive, neuropsychological, psychiatric and behavioral disorders. In the review perampanel demonstrates efficacy and safety, including among adolescents. There were shown the prospects of the usage of perampanel as add-on therapy of focal seizures with or without secondary generalization and a clinical case of application perampanel a patient with refractory epilepsy in adolescence.

В статье представлены современные данные о применении противоэпилептического препарата перампанел в терапии резистентной эпилепсии в повседневной клинической практике у подростков. Несмотря на достаточно развитую систему диагностики и лечения эпилепсии, около одной трети пациентов с недавно диагностированным заболеванием остаются резистентными к медикаментозной терапии. При выборе комбинации противоэпилептических препаратов (ПЭП) для детей и подростков стоит иметь в виду, что для данной группы пациентов успеваемость в школе может во многом предопределить их будущее. В связи с этим наибольшее опасение вызывают такие побочные эффекты ПЭП, как когнитивные, нейропсихологические, психиатрические и поведенческие нарушения. В приведенном обзоре продемонстрирована эффективность и безопасность перампанела, в том числе среди подростков. Показана перспективность применения данного препарата в комбинированной терапии фокальных приступов с вторичной генерализацией или в ее отсутствие. Представлен клинический случай примене- ния перампанела у пациентки с резистентной эпилепсией в подростковом возрасте.

эпилепсияфармакорезистентностьподросткиперампанелepilepsydrug-resistantadolescentsperampanelReferencesВоронкова К.В., Петрухин А.С., Пылаева О.А., Холин А.А. Рациональная антиэпилептическая фармакотерапия. М. 2008; 192 с.Voronkova K.V., Petrukhin A.S., Pylaeva O.A., Kholin A.A. Rational antiepileptic pharmacotherapy [Ratsional’naya antiepilepticheskaya farmakoterapiya (in Russian)]. Moscow. 2008; 192 s.Biró A., Stephani U., Tarallo T., Bast T., Schlachter K., Fleger M., Kurlemann G., Fiedler B., Leiz S., Nikanorova M., Wolff M., Müller A., Selch C., Staudt M., Kluger G. Effectiveness and tolerability of perampanel in children and adolescents with refractory epilepsies: first experiences. Neuropediatrics. 2015 Apr; 46 (2): 110-6. doi : 10.1055/s-0035-1546276. Epub 2015 Mar 2.Biró A., Stephani U., Tarallo T., Bast T., Schlachter K., Fleger M., Kurlemann G., Fiedler B., Leiz S., Nikanorova M., Wolff M., Müller A., Selch C., Staudt M., Kluger G. Effectiveness and tolerability of perampanel in children and adolescents with refractory epilepsies: first experiences. Neuropediatrics. 2015 Apr; 46 (2): 110-6. DOI: 10.1055/s-0035-1546276. Epub 2015 Mar 2.Crépel V., Mulle C., Physiopathology of kainate receptors in epilepsy. Curr Opin Pharmacol. 2015 Feb; 20: 83-8. doi: 10.1016/j.coph.2014.11.012. Epub 2014 Dec 13.Crépel V., Mulle C., Physiopathology of kainate receptors in epilepsy. Curr Opin Pharmacol. 2015 Feb; 20: 83-8. DOI: 10.1016/j.coph.2014.11.012. Epub 2014 Dec 13.Ettinger A.B., LoPresti A., Yang H., Williams B., Zhou S., Fain R., Laurenza A. Psychiatric and behavioral adverse events in randomized clinical studies of the noncompetitive AMPA receptor antagonist perampanel. Epilepsia. 2015 Aug; 56 (8): 1252-63. doi: 10.1111/epi.13054. Epub 2015 Jul 3.Ettinger A.B., LoPresti A., Yang H., Williams B., Zhou S., Fain R., Laurenza A. Psychiatric and behavioral adverse events in randomized clinical studies of the noncompetitive AMPA receptor antagonist perampanel. Epilepsia. 2015 Aug; 56 (8): 1252-63. DOI: 10.1111/epi.13054. Epub 2015 Jul 3.Franco V., Crema F., Iudice A. et al. Novel treatment options for epilepsy: focus on perampanel. Pharmacol Res 2013; 70 (1): 35-40.Franco V., Crema F., Iudice A. et al. Novel treatment options for epilepsy: focus on perampanel. Pharmacol Res. 2013; 70 (1): 35-40.French J.A., Krauss G. L., Biton V. et al. Adjunctive perampanel for refractory partialonset seizures: randomized phase III study 304. Neurology. 2012; 79 (6): 589-96.French J.A., Krauss G. L., Biton V. et al. Adjunctive perampanel for refractory partialonset seizures: randomized phase III study 304. Neurology. 2012; 79 (6): 589-96.French J.A., Krauss G. L., Steinhoff B. J.et al. Evaluation of adjunctive perampanel in patients with refractory partial-onset seizures: results of randomized global phase III study 305. Epilepsia 2013; 54 (1): 117-25.French J.A., Krauss G. L., Steinhoff B. J.et al. Evaluation of adjunctive perampanel in patients with refractory partial-onset seizures: results of randomized global phase III study 305. Epilepsia. 2013; 54 (1): 117-25.Gidal B.E., Laurenza A., Hussein Z., Yang H., Fain R., Edelstein J., Kumar D., Ferry J. Perampanel efficacy and tolerability with enzyme-inducing AEDs in patients with epilepsy. Neurology. 2015 May 12; 84 (19): 1972-80. doi : 10.1212/WNL.0000000000001558. Epub 2015 Apr 15.Gidal B.E., Laurenza A., Hussein Z., Yang H., Fain R., Edelstein J., Kumar D., Ferry J. Perampanel efficacy and tolerability with enzyme-inducing AEDs in patients with epilepsy. Neurology. 2015 May 12; 84 (19): 1972-80. DOI: 10.1212/WNL.0000000000001558. Epub 2015 Apr 15.Kerling F., Kasper B.S. Efficacy of perampanel: a review of clinical trial data. Acta Neurol Scand Suppl. 2013; (197): 25-9.Kerling F., Kasper B.S. Efficacy of perampanel: a review of clinical trial data. Acta Neurol Scand Suppl. 2013; (197): 25-9.Kim H.D., Chi C.S., Desudchit T., Nikanorova M., Visudtibhan A., Nabangchang C., Chan D.W., Fong C.Y., Chang K.P., Kwan S.Y., Reyes F. L., Huang C.C., Likasitwattanakul S., Lee W. T., Yung A., Dash A. Review of clinical studies of perampanel in adolescent patients. Brain Behav. 2016 Jun 28; 6 (9): e00505.Kim H.D., Chi C.S., Desudchit T., Nikanorova M., Visudtibhan A., Nabangchang C., Chan D.W., Fong C.Y., Chang K.P., Kwan S.Y., Reyes F. L., Huang C.C., Likasitwattanakul S., Lee W. T., Yung A., Dash A. Review of clinical studies of perampanel in adolescent patients. Brain Behav. 2016 Jun 28; 6 (9): e00505.Meador K. J., Yang H., Piña-Garza J.E., Laurenza A., Kumar D., Wesnes K.A. Cognitive effects of adjunctive perampanel for partial-onset seizures: A randomized trial. Epilepsia. 2016; 57 (2): 243-251. doi : 10.1111/epi.13279.Meador K. J., Yang H., Piña-Garza J.E., Laurenza A., Kumar D., Wesnes K.A. Cognitive effects of adjunctive perampanel for partial-onset seizures: A randomized trial. Epilepsia. 2016; 57 (2): 243-251. DOI: 10.1111/epi.13279.Krauss G. L., Bar M., Biton V. еt al. Tolerability and safety of perampanel: two randomized dose-escalation studies. Acta Neurol Scand. 2012; 125 (1): 8-15.Krauss G. L., Bar M., Biton V. et al. Tolerability and safety of perampanel: two randomized dose-escalation studies. Acta Neurol Scand. 2012; 125 (1): 8-15.Krauss G. L., Perucca E., Ben-Menachem E. et al. Long-term safety of perampanel and seizure outcomes in refractory partial-onset seizures and secondarily generalized seizures: Results from phase III extension study 307. Epilepsia. 2014; 55 (7): 1058-68.Krauss G. L., Perucca E., Ben-Menachem E. et al. Long-term safety of perampanel and seizure outcomes in refractory partial-onset seizures and secondarily generalized seizures: Results from phase III extension study 307. Epilepsia. 2014; 55 (7): 1058-68.Lagae L., Villanueva V., Meador K. J., Bagul M., Laurenza A., Kumar D., Yang H. Adjunctive perampanel in adolescents with inadequately controlled partial-onset seizures: A randomized study evaluating behavior, efficacy, and safety. Epilepsia. 2016 Jul; 57 (7): 1120-9. doi: 10.1111/epi.13417. Epub 2016 May 25.Lagae L., Villanueva V., Meador K. J., Bagul M., Laurenza A., Kumar D., Yang H. Adjunctive perampanel in adolescents with inadequately controlled partial-onset seizures: A randomized study evaluating behavior, efficacy, and safety. Epilepsia. 2016 Jul; 57 (7): 1120-9. DOI: 10.1111/epi.13417. Epub 2016 May 25.De Liso P., Vigevano F., Specchio N., De Palma L., Bonanni P., Osanni E., Coppola G., Parisi P., Grosso S., Verrotti A., Spalice A., Nicita F., Zamponi N., Siliquini S., Giordano L., Martelli P., Guerrini R., Rosati A., Ilvento L., Belcastro V., Striano P., Vari M.S., Capovilla G., Beccaria F., Bruni O., Luchetti A., Gobbi G., Russo A., Pruna D., Tozzi A. E., Cusmai R. Effectiveness and tolerability of perampanel in children andadolescents with refractory epilepsies – An Italian observationalmulticenter study. Epilepsy Res. 2016 Nov; 127: 93-100. doi: 10.1016/j.eplepsyres.2016.08.021. Epub 2016 Aug 18.De Liso P., Vigevano F., Specchio N., De Palma L., Bonanni P., Osanni E., Coppola G., Parisi P., Grosso S., Verrotti A., Spalice A., Nicita F., Zamponi N., Siliquini S., Giordano L., Martelli P., Guerrini R., Rosati A., Ilvento L., Belcastro V., Striano P., Vari M.S., Capovilla G., Beccaria F., Bruni O., Luchetti A., Gobbi G., Russo A., Pruna D., Tozzi A. E., Cusmai R. Effectiveness and tolerability of perampanel in children andadolescents with refractory epilepsies – An Italian observationalmulticenter study. Epilepsy Res. 2016 Nov; 127: 93-100. DOI: 10.1016/j.eplepsyres.2016.08.021. Epub 2016 Aug 18.Rogawski M.A. Revisiting AMPA receptors as an antiepileptic drug target. Epilepsy Curr. 2011 Mar; 11 (2): 56-63. doi: 10.5698/1535-7511-11.2.56.Rogawski M.A. Revisiting AMPA receptors as an antiepileptic drug target. Epilepsy Curr. 2011 Mar; 11 (2): 56-63. DOI: 10.5698/1535-7511-11.2.56.Rosenfeld W., Conry J., Lagae L., Rozentals G., Yang H., Fain R., Williams B., Kumar D., Zhu J., Laurenza A. Efficacy and safety of perampanel in adolescent patients with drug-resistant partial seizures in three double-blind, placebo-controlled, phase III randomized clinical studies and a combined extension study. Eur J Paediatr Neurol. 2015 Jul; 19 (4): 435-45. doi: 10.1016/j.ejpn.2015.02.008. Epub 2015 Mar 5.Rosenfeld W., Conry J., Lagae L., Rozentals G., Yang H., Fain R., Williams B., Kumar D., Zhu J., Laurenza A. Efficacy and safety of perampanel in adolescent patients with drug-resistant partial seizures in three double-blind, placebo-controlled, phase III randomized clinical studies and a combined extension study. Eur J Paediatr Neurol. 2015 Jul; 19 (4): 435-45. DOI: 10.1016/j.ejpn.2015.02.008. Epub 2015 Mar 5.Schmitz D., Mellor J., Nicoll R.A. Presynaptic kainate receptor mediation of frequency facilitation at hippocampal mossy fiber synapses. Science. 2001 Mar 9; 291 (5510): 1972-6. Epub 2001 Feb 8.Schmitz D., Mellor J., Nicoll R.A. Presynaptic kainate receptor mediation of frequency facilitation at hippocampal mossy fiber synapses. Science. 2001 Mar 9; 291 (5510): 1972-6. Epub 2001 Feb 8.Steinhoff B. J., Ben-Menachem E., Ryvlin P., Shorvon S., Kramer L., Satlin A., Squillacote D., Yang H., Zhu J., Laurenza A. Efficacy and safety of adjunctive perampanel for the treatment of refractory partial seizures: a pooled analysis of three phase III studies. Epilepsia. 2013 Aug; 54 (8): 1481-9. doi: 10.1111/epi.12212. Epub 2013 May 10.Steinhoff B. J., Ben-Menachem E., Ryvlin P., Shorvon S., Kramer L., Satlin A., Squillacote D., Yang H., Zhu J., Laurenza A. Efficacy and safety of adjunctive perampanel for the treatment of refractory partial seizures: a pooled analysis of three phase III studies. Epilepsia. 2013 Aug; 54 (8): 1481-9. DOI: 10.1111/epi.12212. Epub 2013 May 10.Steinhoff B. J., O’Brien T.J., Yang H., Laurenza A., Patten A., Bibbiani F. Efficacy of adjunctive perampanel in adiopatic generalized epilepsy patients with drugresistant primary generalized tonic-clonic seizures by age, sex and race: double-blind placebo-controlled phase III trial. Poster presented at the 1st Congress of the European Academy of Neurology. Berlin. 20-23 June 2015.Steinhoff B. J., O’Brien T.J., Yang H., Laurenza A., Patten A., Bibbiani F. Efficacy of adjunctive perampanel in adiopatic generalized epilepsy patients with drugresistant primary generalized tonic-clonic seizures by age, sex and race: double-blind placebo-controlled phase III trial. Poster presented at the 1st Congress of the European Academy of Neurology. Berlin. 20-23 June 2015.Villanuevaa V., Garcésa M., LópezGonzálezb F.J., Rodriguez-Osoriob X., Toledoc M., Salas-Puigc J., GonzálezCuevasc M., Camposd D., Serratosae J.M., González-Giráldeze B., Maurif J.A., Camachof J. L., Sullerf A., Carre˜nog M., Gómezg J.B., Montoyah J., RodríguezUrangai J., Saiz-Diazj R., González-de la Alejaj J., Castillok A., López-Trigok J., Pozal J. J., Floresm J., Queroln R., Ojedao J., Ginerp P., Molinsq A., Estever P., Baigesra J. J. Safety, efficacy and outcomerelated factors of perampanel over 12months in a real-world setting: The FYDATA study. Epilepsy Research. 2016 (126): 201-210.Villanuevaa V., Garcésa M., LópezGonzálezb F.J., Rodriguez-Osoriob X., Toledoc M., Salas-Puigc J., GonzálezCuevasc M., Camposd D., Serratosae J.M., González-Giráldeze B., Maurif J.A., Camachof J. L., Sullerf A., Carre˜nog M., Gómezg J.B., Montoyah J., RodríguezUrangai J., Saiz-Diazj R., González-de la Alejaj J., Castillok A., López-Trigok J., Pozal J. J., Floresm J., Queroln R., Ojedao J., Ginerp P., Molinsq A., Estever P., Baigesra J. J. Safety, efficacy and outcomerelated factors of perampanel over 12months in a real-world setting: The FYDATA study. Epilepsy Research. 2016 (126): 201-210.

The authors declare that there are no conflicts of interest present.