Abstract Details

Title Effectiveness and Safety of Perampanel in Patients with Lennox-Gastaut Syndrome: A Single-arm Meta-analysis with Meta-regression and Sensitivity Analyses

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P6 - Poster Session 6 (5:00 PM-6:00 PM)

Poster/Presentation
Number 11-009

Objective To evaluate the efficacy and safety of perampanel in patients with LGS.

Background Lennox-Gastaut syndrome (LGS) is characterized by multiple types of drug-resistant seizures that begin before 18 years of age, including at least one tonic seizure, and are commonly associated with cognitive and behavioral impairments. Perampanel, a non-competitive antagonist of AMPA-type glutamate receptors, has emerged as a potential therapeutic strategy to disrupt the underlying excitatory mechanisms of this syndrome.

Design/Methods Inclusion was limited to randomized controlled trials (RCTs) or observational studies involving patients with confirmed LGS who received perampanel. A systematic review and meta-analysis were conducted in accordance with PRISMA and Cochrane guidelines. PubMed, Embase, and Cochrane Central databases were searched up to July 2025. Pooled analyses were performed using a single-proportion meta-analysis with 95% confidence intervals (CI). Statistical analysis was conducted using OpenMeta Analyst Version 3.1 (PROSPERO CRD420251078418).

Results 14 studies comprising 330 patients were included. The pooled ≥50% responder rate was 46.4% (95% CI 33.6 to 59.2; p<0.001), ≥75% responder rate 23.3% (7.3 to 39.4; p=0.002), seizure freedom 8.2% (1.6 to 14.8; p=0.008), and seizure aggravation 6.0% (0.5 to 11.5; p=0.044). Reported adverse events included somnolence (13.7%), irritability (11.3%), aggression (10.7%), dizziness (5.3%), agitation (3.9%), and psychiatric symptoms (17.1%). Heterogeneity was substantial; sensitivity analysis was robust; no temporal effect on response.

Conclusions

Perampanel demonstrated clinically meaningful seizure reduction and acceptable tolerability in LGS. These results support its adjunctive use, though larger RCTs are needed to confirm long-term efficacy and safety.

Authors/Disclosures
Carolina A. Corrêa, Medical Student PRESENTER	Ms. Corrêa has nothing to disclose.
Amanda Rabelo	Miss Rabelo has nothing to disclose.
Yasmim Nunes, Medical Student	Miss Nunes has nothing to disclose.
Julia F. Oliveira, MD	Dr. Oliveira has nothing to disclose.
Gabriela D. Carolino	Miss Carolino has nothing to disclose.
Daniel C. Castro, Medical Student	Mr. Castro has nothing to disclose.

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