Fycompa (perampanel) / Eisai, Grupo Biotoscana, Catalyst Pharma - LARVOL DELTA

Expanding the toolkit: An update on the evolution of new therapies for Lennox-Gastaut Syndrome. (PubMed, Semin Pediatr Neurol) - "The purpose of this paper is to address three such aspects of treatment evolution for LGS: (1) To review data supporting the repurposing of existing drugs for use in LGS, specifically, perampanel and cenobamate. (2) To present recent (soticlestat), ongoing (carisbamate, bexicaserin, clemizole) and upcoming (opakalim) clinical drug trials for LGS...With the richness of recent trial development for LGS combined with the nascence of clinical trials for specific genetic epilepsies comes a new era in which treatment options for LGS will continue to expand. Increasing understanding of the underlying genetic and molecular underpinnings of LGS should enable development of unique therapies, with the continued aims of sustained, durable seizure control and additional positive impact on central nervous system outcomes and beyond."

Journal • Review • Alzheimer's Disease • CNS Disorders • Cognitive Disorders • Epilepsy

Association of Aggression and Anti-seizure Medications in Pediatric Patients: Disproportionality Analysis Using the FDA Adverse Event Reporting System. (PubMed, Eur J Pharmacol) - "Signals of aggression related to different ASMs were identified. Significantly strong signals were observed for perampanel, levetiracetam and brivaracetam. Compared to infants and preschooler, ASMs-associated aggression is more common in school children and teenagers."

Adverse events • Journal • CNS Disorders • Epilepsy • Pediatrics

Treatment approaches in posthypoxic myoclonus: A narrative review with expert opinion. (PubMed, Epilepsia) - "Treatment remains largely empirical and variable, with benzodiazepines and antiseizure medications (e.g., levetiracetam, valproate, clonazepam, perampanel) being commonly used. Acute PHM is a clinically heterogeneous disorder with significant diagnostic and therapeutic challenges. Future research should focus on refining diagnostic criteria and identifying targeted therapies to improve outcomes in this often-fatal condition."

Journal • Review • Cardiovascular • CNS Disorders • Epilepsy • Movement Disorders

Combined adjunctive Perampanel and Memantine with standard of care chemoradiotherapy in newly diagnosed glioblastoma patients led to longer adjuvant treatment and prolonged functional independence: a single institution case series (SNO 2025) - "Historically, 47% of glioblastoma patients completed six cycles of adjuvant temozolomide. At 10 months, 5/8 (62.5%) maintained KPS>60, with 4/8 (50%) MGMT unmethylated patients sustaining KPS>90 for over 6 months. Conclusions : Adding perampanel and memantine to standard chemoradiotherapy may extend chemotherapy treatment duration and prolong functional independence in both MGMT unmethylated and methylated glioblastoma patients, potentially improving overall outcomes."

Clinical • Brain Cancer • Glioblastoma • Glioma • Solid Tumor • MGMT

Targeting glioma-neuronal circuit remodeling to overcome immunosuppression: functional and therapeutic insights (SNO 2025) - "Notably, this immunosuppressive TME was alleviated either by eliminating tumor-derived TSP1 or by treatment with perampanel (PER), which inhibits glutamatergic excitatory signaling...In summary, our findings highlight the intricate crosstalk between glioma, neurons, and immune cells as a pivotal therapeutic vulnerability. Targeting neuronal activity may represent a promising strategy to modulate the immunosuppressive TME in GBM and enhance the efficacy of immunotherapeutic modalities, such as CAR-T cell therapy."

Brain Cancer • Glioblastoma • Glioma • Solid Tumor • CD8

EpiTrack: Direct and indirect role in the assessment of executive functions and memory - Systematic review. (PubMed, Appl Neuropsychol Adult) - "Perampanel and Cenobamate exhibited a neutral cognitive profile, with scores stable at "moderate impairment" (29.67-30.04). Lamotrigine and Levetiracetam demonstrated persistent severe impairment. Brivaracetam improved from severe to moderate impairment (not clinically significant). Only Topiramate showed a clinically significant decline (30.0 to 26.6)...In contrast, VNS with 3-4 AEDs maintained severe impairment. This review underscores the importance of accurate cognitive assessment in epilepsy management, with a monitoring frequency of no more than every six months for patients receiving AED therapy."

Journal • Review • Alzheimer's Disease • CNS Disorders • Cognitive Disorders • Epilepsy

IQSEC2-related phenotypes, epilepsy and epilepsy treatment: in international multicentre case series including 26 children (AES 2025) - "Our case series complements previous publications and confirms some of their findings. There are some differences in terms of development and epilepsy. We also investigated therapeutic options and and whether perampanel represents a promising antiseizure medication."

Clinical • Late-breaking abstract • Autism Spectrum Disorder • CNS Disorders • Developmental Disorders • Epilepsy • Genetic Disorders • Mental Retardation • Psychiatry

Pre-Ictal Asystole in Refractory Epilepsy: A Video Case Report (AES 2025) - "Medications included lacosamide and lamotrigine...The patient was discharged on Perampanel 4 mg daily, and according to the parent's report on a follow up visit, there has been significant improvement, with no new seizures of any type observed. Our case is unique given a long pre-ictal asystole, as most literature regarding ictal asystole suggests it occurs at or following ictal onset... Our case is unique given a long pre-ictal asystole, as most literature regarding ictal asystole suggests it occurs at or following ictal onset. While the asystole in our case occurred during lab draws, the preceding junctional rhythms and pauses suggest a more complex interplay between autonomic instability and this seizure's onset rather than vasovagal response. Also, lack of EEG changes prior to and during asystole suggest against hypoperfusion-induced seizure."

Case report • Clinical • Video • Cardiovascular • CNS Disorders • Epilepsy

Cenobamate in real world : a single center study (AES 2025) - "68 patients had a proactive decrease in one or several concomitant ASM dosage, mainly lacosamide (N=25), perampanel (N=14), clobazam (N=12). 51 patients needed a further decrease in other ASM dosage (mainly brivaracetam and lacosamide), and 52 patients could stop at least one concomitant ASM (mainly lacosamide and perampanel)... Efficacy of CNB is confirmed in this real world series of patients. After one year of follow up, the efficacy is maintained with 52% of the patients being either seizure free or responders. Side effects are common and in line with those found in regulatory studies."

Clinical • Real-world • Real-world evidence • Ataxia • CNS Disorders • Epilepsy • Movement Disorders

Effect of Perampanel on Sleep, Daytime Sleepiness, Anxiety, and Depression in Adult Patients with Epilepsy in Real-World Clinical Practice (AES 2025) - "PER as part of complex therapy for epilepsy in adults showed a high retention rate, acceptable safety profile, significantly improved sleep quality and reduced daytime sleepiness. Complex therapy using PER had an additional anti-anxiety effect."

Clinical • Real-world • Real-world evidence • CNS Disorders • Depression • Epilepsy • Insomnia • Mood Disorders • Psychiatry • Sleep Disorder

Efficacy and Tolerability of RAP-219, a Potential First-in-Class Negative Allosteric Modulator of γ8 Transmembrane AMPA Receptor Associated Protein: Impact on RNS Long Episodes and Focal Seizures (AES 2025) - "Use of perampanel was exclusionary...The most common ASMs were lamotrigine, cenobamate, levetiracetam, zonisamide, and clobazam... The baseline characteristics of the patients enrolled in this innovative POC study testing the electrographic and clinical effect of RAP-219 in RNS patients with FOS are similar to those reported in contemporary Phase 2 and 3 studies. Efficacy, safety, and tolerability of RAP-219 (to be reported) as evaluated during the 8-week, open-label treatment trial are expected to be highly relevant to patients with drug-resistant FOS."

Clinical • Late-breaking abstract • CNS Disorders • Epilepsy

Impact of antiseizure medication on thyroid function in children with newly diagnosed epilepsy: A single-center experience (AES 2025) - "ASMs included levetiracetam (41.7%), oxcarbazepine (20.8%), valproic acid (16.7%), lamotrigine (12.5%), and perampanel (8.3%). Our findings suggest that standard-dose ASM monotherapy does not significantly affect thyroid function in pediatric epilepsy patients. These results support the thyroid safety profile of newer ASMs, particularly levetiracetam and lamotrigine, consistent with previous studies."

Clinical • CNS Disorders • Endocrine Disorders • Epilepsy

Mid-South Single Center Experience of Status Epilepticus with Autoimmune Encephalitis (AES 2025) - "The patient with anti-ganglionic nicotinic ACh receptor encephalitis presented with seizures along with focal motor weakness developed cardiac arrest possibly due to autonomic dysfunction [5], resuscitated and later improved with PLEX and IVIG followed by immunosuppression with mycophenolate mofetil. The seizures were treated predominantly with levetiracetam, lacosamide, phenobarbital and perampanel. Our retrospective case series study showed that despite having long ICU stay and ventilator days, 85% of the patients with new onset refractory status epilepticus due to autoimmune encephalitis improved with high dose steroids, PLEX and/ or IVIG except for one patient with anti-NMDA receptor positive with extreme delta brush pattern who died [3]. EBV IgG positive in CSF in one patient with anti-NMDA receptor encephalitis suggests the possibility of EBV infection being trigger for anti-NMDA encephalitis[4]."

Clinical • Cardiovascular • CNS Disorders • Epilepsy • Epstein-Barr Virus Infections • Immunology • Infectious Disease • Psychiatry • Respiratory Diseases

A prospective study of the efficacy and safety of Perampanel in the treatment of Post-Stroke Epilepsy (AES 2025) - "The clinical efficacy and safety of Perampanel as an adjunctive therapy for PSE are promising, with a strong drug retention rate. Perampanel offers an effective therapeutic option for the management of PSE."

Clinical • Late-breaking abstract • Cardiovascular • Cerebral Hemorrhage • CNS Disorders • Epilepsy • Hematological Disorders • Ischemic stroke

Epilepsy-Related and All-Cause Healthcare Resource Utilization After Initiation of Adjunctive Cenobamate (AES 2025) - "The aim of this study was to evaluate the comparative effect of initiating cenobamate vs selected ASMs (brivaracetam, clobazam, eslicarbazepine, lacosamide, or perampanel) on epilepsy-related and all-cause inpatient (IP) and emergency room (ER) utilization rates. A retrospective observational study using de-identified electronic health records (EHRs) from 28 healthcare organizations representing ambulatory centers, hospitals, imaging centers, and clinics and medical offices (the Truveta database) identified adults (≥18 years) with an epilepsy diagnosis who initiated cenobamate or another selected ASM between January 1, 2020 and Dec 5, 2024. Initiation of cenobamate was associated with a significant reduction in both epilepsy-related and all-cause IP admissions and ER visits as compared to propensity-matched patients who similarly could likely have initiated cenobamate, but instead initiated other ASMs. The mechanism for why cenobamate was associated with fewer IP..."

HEOR • CNS Disorders • Epilepsy

Mortality Risk After Initiation of Cenobamate or Other Antiseizure Medications (AES 2025) - "The present real-world study examined the all-cause mortality rate in patients after initiating cenobamate vs the mortality rate in patients treated with selected antiseizure medications (ASMs) that have similar patterns of use in medication-resistant epilepsy. A retrospective observational study using de-identified electronic health records from 28 US health systems (Truveta) identified adults (≥18 years) with an epilepsy diagnosis who initiated therapeutic doses of cenobamate or another selected ASM (brivaracetam, clobazam, lacosamide, eslicarbazepine, or perampanel) between 1/1/2020-12/5/2024. This retrospective analysis shows that patients treated with cenobamate at therapeutic doses had lower mortality rates than patients treated with selected comparable ASMs commonly used for medication-resistant epilepsy. Further exploration of these results are needed to compare to other ASMs and non-ASM treatment options (e.g., surgery and neuromodulation), to compare to..."

CNS Disorders • Epilepsy

Idiopathic generalized epilepsies exacerbated by sodium channel blockers: a 10-case analysis for the reasons and consequences of misuse (AES 2025) - "Oxcarbazepine was prescribed to 7 patients and was the first ASM in 2 patients, carbamazepine to 2 patients and lacosamide to 1 patient...There was also EEG worsening, including multifocal spikes in 8 and fast rhythmic activity in 6 cases.Discontinuation of SCBs and optimization of ASMs to valproate, lamotrigine, levetiracetam, perampanel or clobazam resulted in seizure control in 9 patients after a median time of 9.5 months... SCBs exacerbate seizures and EEG abnormalities in IGEs. Focal EEG features and atypical semiology can lead to the misuse of SCBs. Adherence to IGE treatment guidelines, which involve avoiding SCBs and prioritizing broad-spectrum ASMs, is essential to prevent disease progression and reduce the healthcare burden."

Clinical • Absence Seizure Disorder • CNS Disorders • Epilepsy

Perampanel in Elderly South Korean Patients: An Open-Label, Multicenter, Real-World Study (AES 2025) - "This study demonstrated that although the retention rate of perampanel in elderly patients in Korea was somewhat lower compared to previous reports, the incidence of adverse effects was not high, indicating comparable safety. Notably, the responder rate remained high even over a long-term follow-up period of up to three years. These favorable outcomes were particularly evident in the monotherapy and early add-on groups, suggesting that perampanel may be a valuable treatment option in these patient populations."

Clinical • Real-world • Real-world evidence • CNS Disorders • Epilepsy

Clinical Efficacy and Safety of Perampanel Monotherapy for the Treatment of Epilepsy: A Systematic Review and Meta-Analysis (AES 2025) - "PER monotherapy appears to be an effective and well-tolerated treatment option for both focal and generalized epilepsy. Efficacy and retention are particularly favorable in pediatric populations. These findings support the role of PER monotherapy as a viable treatment option in routine clinical practice and underscore the need for further comparative studies across age groups and against other first-line antiseizure medications."

Monotherapy • Retrospective data • Review • CNS Disorders • Epilepsy

Real-world effectiveness and tolerability of perampanel in Korean patients with epilepsy: A single-center study (AES 2025) - "Perampanel showed favorable long-term effectiveness and tolerability in this real-world Korean study. Patients with psychiatric comorbidities or using enzyme-inducing ASMs may have a higher risk of AEs and suboptimal outcomes, suggesting cautious use or avoidance of perampanel in these groups. In contrast, perampanel appears well-tolerated when added to lamotrigine or levetiracetam."

Clinical • Real-world • Real-world effectiveness • Real-world evidence • Ataxia • CNS Disorders • Depression • Epilepsy • Movement Disorders • Psychiatry

Exposure to Curriculum-Based Education Increases the Evidence-Based Use of Newer Anti-Seizure Medications for the Management of Focal Epilepsy Among Neurologists (AES 2025) - "Neurologist learners across the 3 CME programs were matched to claims data to identify them as prescribers of newer ASMs (defined as: brivaracetam, cenobamate, eslicarbazepine, lacosamide, and perampanel) in the 6 months prior to participation and 3 months after program participation relative to a propensity matched group of neurologists who did not participate in the educational programming. The reported data indicated that positive improvements in knowledge and competence across CME programming on the use of newer ASMs can translate to improvements in the clinical use of such medications. The next step is to determine if similar claims results are found 6 months after taking the CME programming."

CNS Disorders • Epilepsy

Long-term Impact of Cenobamate on Cognition in Patients with Drug-Resistant Focal Epilepsy: Outcomes from an Exploratory Real-World Study. (PubMed, Neurol Ther) - "In this exploratory, real-world study, we observed significant improvements in seizure frequency, concomitant ASM usage, and cognition at up to 18 months of cenobamate treatment in patients with drug-resistant focal epilepsy."

Journal • Real-world evidence • CNS Disorders • Epilepsy

Clinical practice guidelines for the administration of third-generation anti-seizure medications. (PubMed, Seizure) - "This guideline provides a detailed evaluation of the current evidence and treatment recommendations regarding third-generation ASMs. This guideline will help clinicians to better understand these medications and offer guidance for clinical practice."

Clinical guideline • Journal • Review • CNS Disorders • Epilepsy

Economic evaluation of brivaracetam in the adjunctive treatment of patients with focal-onset seizure in Jordan. (PubMed, Medicine (Baltimore)) - "In addition to BRV, 3 treatment comparators were included in this economic evaluation: eslicarbazepine (ESL), lacosamide (LCM), and perampanel (PER). Compared to ESL and PER, BRV was associated with cost-savings. Compared to LCM, the BRV was cost-effective at the World Health Organization recommended willingness-to-pay threshold of 3× of Jordanian gross domestic product per capita."

HEOR • Journal • CNS Disorders • Epilepsy

The real-world safety of lacosamide and perampanel in children: a disproportionality analysis of the FDA Adverse Event Reporting System. (PubMed, Ther Adv Drug Saf) - "This postmarketing study provided reference data for the clinical monitoring and treatment of lacosamide and perampanel in children. Our study merely proved the statistical correlations; further research is needed to clarify the causal relationship between the drug and the AEs."

Adverse events • Journal • Real-world evidence • Cardiovascular • CNS Disorders • Infectious Disease • Mental Retardation • Psychiatry