Introduction

Perampanel (trade name: Fycompa) has been approved in Germany since July 2012 as an add-on treatment for epileptic seizures in children over the age of 12 and adults.

Epileptic seizures are triggered by abnormal activity in the nerve cells of the brain. They can cause reduced consciousness, altered awareness and muscle twitching, as well as severe convulsions and discomfort. A seizure usually lasts between a few seconds and a few minutes.

Epileptic seizures are classified as either partial (focal) or generalized, depending on how much of the brain is affected.

Partial seizures only affect a small part of the brain, with muscle twitching or convulsions only occurring in certain parts of the body. Partial seizures can, however, spread across the whole body – this is called “secondary generalization.”

Generalized seizures affect the entire body. Brief episodes of confusion or drowsiness are common. During a tonic-clonic seizure, the person’s body becomes stiff and they stop breathing for a short while. Then the muscles start twitching rhythmically, and this is followed by exhaustion.

Perampanel can be used in addition to basic treatment – for the treatment of partial seizures with or without secondary generalization, as well as for the treatment of tonic-clonic seizures in generalized epilepsy.

Application

Perampanel is used in addition to basic treatment.

The drug is taken once a day in the form of a tablet before going to bed. The dose is individually tailored, and the maximum recommended dose is 12 mg per day.

Other treatments

Epilepsy treatment is individually adjusted by the doctor. It will depend on the basic treatment, which drugs have already been used and other factors.

Assessment

In 2018, the Institute for Quality and Efficiency in Health Care (IQWiG, Germany) wanted to find out whether perampanel has any advantages or disadvantages in people over the age of 12 with generalized epilepsy and tonic-clonic seizures when compared with conventional add-on treatments.

But the manufacturer did not provide any suitable data with which to do the assessment.

More information

This information summarizes the main results of a review produced by the Institute for Quality and Efficiency in Health Care (IQWiG, Germany). The review was commissioned by the German Federal Joint Committee (G-BA) as part of the “early benefit assessment of medications.” On the basis of the review and the hearings received, the G-BA passed a resolution on the added benefit of Perampanel (Fycompa).