Patients with a particular form of epilepsy in the UK can now access Eisai’s Fycompa to reduce serious seizures after regulators expanded the scope of the anti-convulsant’s reach last month.

The once-daily pill is now available across the country to reduce primary generalised tonic-clonic (PGTC) seizures in adults and adolescents with idiopathic generalised epilepsy (IGE), having been available in the UK since 2012 as an adjunctive treatment of partial onset seizures with or without secondarily generalised seizures. 

Around a third of patients have the idiopathic generalised form of epilepsy, of which 60% (91,200 people), will experience primary generalised tonic-clonic seizures, leaving them vulnerable to injury such as fractured bones, shoulder dislocation and burns.

PGTC seizures also increase the risk of sudden unexplained death in epilepsy (SUDEP), which accounts for 1,000 deaths a year in the UK, and are also known to lead to atypical absence status epilepticus, seizures that may last for extended periods of time. 

In clinical trials, one third more patients experienced a reduction in seizure frequency with Fycompa (perampanel) over 28 days versus placebo, and 31% of patients remained seizure free during the 13-week maintenance period when treated with the drug as an adjunctive therapy, compared to 12% in the placebo group. The most common side effects reported were dizziness, fatigue, headache, somnolence and irritability.

Patients will undoubtedly welcome the option of treatment with a first-in-class therapy - the first-and-only licensed anti-epileptic to selectively target the initiation and spread of seizures through inhibition of AMPA receptors - particularly as as many as 20% of those with IGE remain uncontrolled, despite current treatment.