Efficacy of Perampanel in Refractory and Super-Refractory Status Epilepticus with Suspected Inflammatory Etiology: A Case Series
(1) Background: Increasing evidence supports the anti-inflammatory and neuroprotective role of perampanel (PER), mediated by decreased expression of pro-inflammatory cytokines and by interference with apoptosis processes. Therefore, the use of PER to treat status epilepticus (SE) with suspected infl...
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MDPI AG
2023-12-01
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| Online Access: | https://www.mdpi.com/1424-8247/17/1/28 |
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| author | Annacarmen Nilo Alberto Vogrig Marco Belluzzo Christian Lettieri Lorenzo Verriello Mariarosaria Valente Giada Pauletto |
| author_facet | Annacarmen Nilo Alberto Vogrig Marco Belluzzo Christian Lettieri Lorenzo Verriello Mariarosaria Valente Giada Pauletto |
| author_sort | Annacarmen Nilo |
| collection | DOAJ |
| description | (1) Background: Increasing evidence supports the anti-inflammatory and neuroprotective role of perampanel (PER), mediated by decreased expression of pro-inflammatory cytokines and by interference with apoptosis processes. Therefore, the use of PER to treat status epilepticus (SE) with suspected inflammatory etiology is appealing and deserves further investigation. (2) Methods: We retrospectively analyzed seven patients (five F, two M; median age: 62 years) with refractory and super-refractory SE due to a probable or defined inflammatory etiology and treated with PER. (3) Results: PER was administered as the third (4/7) or fourth drug (3/7), with a median loading dose of 32 mg/day (range: 16–36 mg/day) and a median maintenance dose of 10 mg/day (range: 4–12 mg/day). In five cases, SE was focal, while in two patients, it was generalized. SE was caused by systemic inflammation in three patients, while in the other four subjects, it was recognized to have an autoimmune etiology. SE resolution was observed after PER administration in all cases, particularly within 24 h in the majority of patients (4/7, 57.1%). (4) Conclusions: Our data support the efficacy of PER in treating SE when first- and second-line ASMs have failed and suggest a possible earlier use in SE cases that are due to inflammatory/autoimmune etiology. |
| first_indexed | 2024-03-08T10:38:11Z |
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| id | doaj.art-2c1ac19d14934a2482d31ef3e6d4f329 |
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| issn | 1424-8247 |
| language | English |
| last_indexed | 2024-03-08T10:38:11Z |
| publishDate | 2023-12-01 |
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| spelling | doaj.art-2c1ac19d14934a2482d31ef3e6d4f3292024-01-26T18:04:56ZengMDPI AGPharmaceuticals1424-82472023-12-011712810.3390/ph17010028Efficacy of Perampanel in Refractory and Super-Refractory Status Epilepticus with Suspected Inflammatory Etiology: A Case SeriesAnnacarmen Nilo0Alberto Vogrig1Marco Belluzzo2Christian Lettieri3Lorenzo Verriello4Mariarosaria Valente5Giada Pauletto6Clinical Neurology Unit, Department of Head, Neck and Neurosciences, Santa Maria della Misericordia University Hospital, 33100 Udine, ItalyClinical Neurology Unit, Department of Head, Neck and Neurosciences, Santa Maria della Misericordia University Hospital, 33100 Udine, ItalyNeurology Unit, Department of Head, Neck and Neurosciences, Santa Maria della Misericordia University Hospital, 33100 Udine, ItalyClinical Neurology Unit, Department of Head, Neck and Neurosciences, Santa Maria della Misericordia University Hospital, 33100 Udine, ItalyNeurology Unit, Department of Head, Neck and Neurosciences, Santa Maria della Misericordia University Hospital, 33100 Udine, ItalyClinical Neurology Unit, Department of Head, Neck and Neurosciences, Santa Maria della Misericordia University Hospital, 33100 Udine, ItalyNeurology Unit, Department of Head, Neck and Neurosciences, Santa Maria della Misericordia University Hospital, 33100 Udine, Italy(1) Background: Increasing evidence supports the anti-inflammatory and neuroprotective role of perampanel (PER), mediated by decreased expression of pro-inflammatory cytokines and by interference with apoptosis processes. Therefore, the use of PER to treat status epilepticus (SE) with suspected inflammatory etiology is appealing and deserves further investigation. (2) Methods: We retrospectively analyzed seven patients (five F, two M; median age: 62 years) with refractory and super-refractory SE due to a probable or defined inflammatory etiology and treated with PER. (3) Results: PER was administered as the third (4/7) or fourth drug (3/7), with a median loading dose of 32 mg/day (range: 16–36 mg/day) and a median maintenance dose of 10 mg/day (range: 4–12 mg/day). In five cases, SE was focal, while in two patients, it was generalized. SE was caused by systemic inflammation in three patients, while in the other four subjects, it was recognized to have an autoimmune etiology. SE resolution was observed after PER administration in all cases, particularly within 24 h in the majority of patients (4/7, 57.1%). (4) Conclusions: Our data support the efficacy of PER in treating SE when first- and second-line ASMs have failed and suggest a possible earlier use in SE cases that are due to inflammatory/autoimmune etiology.https://www.mdpi.com/1424-8247/17/1/28status epilepticusperampanelneuroinflammationtreatmentretrospective study |
| spellingShingle | Annacarmen Nilo Alberto Vogrig Marco Belluzzo Christian Lettieri Lorenzo Verriello Mariarosaria Valente Giada Pauletto Efficacy of Perampanel in Refractory and Super-Refractory Status Epilepticus with Suspected Inflammatory Etiology: A Case Series Pharmaceuticals status epilepticus perampanel neuroinflammation treatment retrospective study |
| title | Efficacy of Perampanel in Refractory and Super-Refractory Status Epilepticus with Suspected Inflammatory Etiology: A Case Series |
| title_full | Efficacy of Perampanel in Refractory and Super-Refractory Status Epilepticus with Suspected Inflammatory Etiology: A Case Series |
| title_fullStr | Efficacy of Perampanel in Refractory and Super-Refractory Status Epilepticus with Suspected Inflammatory Etiology: A Case Series |
| title_full_unstemmed | Efficacy of Perampanel in Refractory and Super-Refractory Status Epilepticus with Suspected Inflammatory Etiology: A Case Series |
| title_short | Efficacy of Perampanel in Refractory and Super-Refractory Status Epilepticus with Suspected Inflammatory Etiology: A Case Series |
| title_sort | efficacy of perampanel in refractory and super refractory status epilepticus with suspected inflammatory etiology a case series |
| topic | status epilepticus perampanel neuroinflammation treatment retrospective study |
| url | https://www.mdpi.com/1424-8247/17/1/28 |
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