Efficacy and safety of perampanel in the subgroup of elderly patients included in the phase III epilepsy clinical trials

- Perampanel (PER) is an adjunctive therapy for refractory partial-onset seizures.
- Subanalysis of subjects aged ≥65 years who participated in PER phase III trials.
- Efficacy was similar in the elderly subgroup compared to the adult population.
- Safety also similar, except for falls, dizziness, fatigue, and balance disorder.
- Titration of PER in elderly should proceed cautiously, especially at higher doses.

SummaryClinical data regarding use of antiepileptic drugs in the elderly are generally scarce. Therefore, a subanalysis of subjects aged ≥65 years who participated in the 3 phase III perampanel studies was undertaken to determine efficacy and safety in these patients. Efficacy (change in seizure frequency/28 days and 50% responder rate) in the elderly subgroup was found to be consistent with the adult population. Adverse event rates were also largely similar, with some exceptions. Because risks of falls, dizziness, and fatigue were greater in the elderly, careful titration of perampanel in patients aged ≥65 years is suggested, especially at higher doses, where balancing tolerability and clinical response is necessary.