Shankar, R;
Henley, W;
Wehner, T;
Wiggans, C;
McLean, B;
Pace, A;
Mohan, M;
... Sander, JW; + view all
(2017)
Perampanel in the general population and in people with intellectual disability: Differing responses.
Seizure
, 49
pp. 30-35.
10.1016/j.seizure.2017.05.012.
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Abstract
Purpose There is a shortfall of suitably powered studies to provide evidence for safe prescribing of AEDs to people with Intellectual Disability (ID). We report clinically useful information on differences in response to Perampanel (PER) adjunctive treatment for refractory epilepsy between ID sub-groups and general population from the UK Ep-ID Research Register. Method Pooled retrospective case notes data of consented people with epilepsy (PWE) prescribed PER from 6 UK centres was classified as per WHO guidance into groups of moderate -profound ID, mild ID and General population. Demographics, concomitant AEDs, starting and maximum dosage, exposure length, adverse effects, dropout rates, seizure type and frequency were collected. Group differences were reported as odds ratios estimated from univariable logistic regression models. Results Of the 144 PWE (General population 71, Mild ID 48, Moderate to profound ID 48) examined the association between withdrawal and ID type was marginally statistically significant (p = 0.07). Moderate to profound ID PWE were less likely to come off PER compared to mild ID (OR = 0.19, CI = 0.04–0.92, p = 0.04). Differences in mental health side effects by groups was marginally statistically significant (p = 0.06). Over 50% seizure improvement was seen in 11% of General population, 24% mild ID and 26% Moderate to profound ID. Conclusions PER seems safe in PWE with ID. It is better tolerated by PWE with Moderate to profound ID than PWE with higher functioning. Caution is advised when history of mental health problems is present. The standardised approach of the Ep-ID register UK used confirms that responses to AEDs by different ID groups vary between themselves and General population.
| Type: | Article |
|---|---|
| Title: | Perampanel in the general population and in people with intellectual disability: Differing responses |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.seizure.2017.05.012 |
| Publisher version: | http://doi.org/ 10.1016/j.seizure.2017.05.012 |
| Language: | English |
| Additional information: | This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Clinical Neurology, Neurosciences, Neurosciences & Neurology, Epilepsy, Intellectual disability, UK Ep-ID research Register, Perampanel, CLINICAL-EXPERIENCE, ADULT PATIENTS, EPILEPSY, PREVALENCE, MORTALITY |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Experimental Epilepsy |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1558545 |
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