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Thursday, November 30, 2017

Efficacy and safety of perampanel in Parkinson's disease.

November 30, 2017

Perampanel is a non-competitive AMPA-type glutamate receptor antagonist, being assessed for use in the treatement of Parkinson's Disease. An extensive assessment of perampanel, including trials involving thousands of patients was carried out concerning its efficacy and safety.

Four daily doses were assessed : 0.5mg, 1mg, 2mg, 4mg. However, no difference was found between the effect of perampanel and the effect of a placebo.

Therefore, perampanel was found to be ineffective. The adverse effects were also similar for perampanel and a placebo, at least confirming its safety.

Reference : British Journal of Pharmacology [2017] Jul 1 [Epub ahead of print] (D.Lindenbach, B.Das, M.Conti, S.M.Meadows, A.K.Dutta, C.Bishop)

http://www.viartis.net/parkinsons.disease/news.htm

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Complete Abstract:

Efficacy and safety of perampanel in Parkinson's disease. A systematic review with meta-analysis.

Lattanzi S1, Grillo E2, Brigo F3,4, Silvestrini M5

Abstract

BACKGROUND:

L-Dopa represents the mainstay of therapy of Parkinson's disease (PD), but its effectiveness is reduced with continued treatment and disease progression. Accordingly, there remains a need to explore novel treatment strategies to manage the signs and symptoms of the later disease stages. The aim of the study was to evaluate the efficacy and safety of adjunctive perampanel (PER) in patients with PD through a meta-analysis of existing trials.

METHODS:

Randomized, placebo-controlled, double- or single-blind, add-on studies of PER in patients with PD were identified through a systematic literature search. The following outcomes were assessed: changes from baseline to final efficacy visit in total daily OFF time, activities of daily living during OFF time and motor function during ON time, incidence of adverse events (AEs), and treatment withdrawal.

RESULTS:

Four trials were included involving 2266 participants, 1449 and 817 for PER and placebo treatment groups, respectively. Four PER daily doses were tested, namely 0.5, 1, 2 and 4 mg. There were no significant differences in any efficacy outcome between PER and placebo treated patients. The risk ratios (RRs) for AEs, severe AEs and treatment withdrawal were similar between placebo and PER at 0.5, 1 and 2 mg; the 4 mg daily dose was associated with an increased risk of AEs [RR 1.118 (1.047-1.193)], and withdrawal for AEs [RR 1.345 (1.034-1.749)] and for any reason [RR 1.197 (1.020-1.406)].