071 Perampanel as early add-on therapy for focal-onset and generalised-onset seizures in clinical practice

Data from 44 pooled clinical practice studies were compared for epilepsy patients with focal-onset and/or generalised-onset seizures treated with perampanel (PER) as early (n=632) versus late add-on therapy (n=1900). Retention was assessed after 3, 6 and 12 months of PER treatment. Effectiveness assess- ments comprised responder rate (≥50% seizure frequency reduction), seizure freedom rate and rate of unchanged or worsening seizure frequency. Adverse events (AEs) and discontinuation due to AEs were evaluated. Retention was significantly higher with early versus late add-on therapy at all timepoints. At last visit, seizure freedom rate was significantly higher with early versus late add-on therapy (40.1% vs. 8.7%; p<0.001), as was responder rate (73.0% vs. 36.4%; p<0.001); and the proportion of patients with unchanged seizure frequency was significantly lower in the early versus late add-on group (10.2% vs. 31.8%; p<0.001), as was worsening seizure frequency (6.1% vs. 13.6%; p<0.001). Patients treated with early versus late add-on therapy had a significantly lower incidence of AEs (41.8% vs. 54.5%; p<0.001), psychi- atric AEs (18.3% vs. 22.2%; p=0.046), and discontinuation rates due to AEs at 12 months (15.0% vs.18.7%; p=0.045). In conclusion, PER was significantly more effective and better-tolerated as early add-on therapy in everyday clinical practice.Supported by Eisai.