Name: Azetukalner (XEN1101) in Focal onset seizures: AMPA receptor antagonists
Published: 2026-09-21T21:41:53-04:00

Product information and disease description Place of product in therapy Approaches to treatment Current treatment options and standard of care

AMPA receptor antagonists

6 evidence topics · 5 sources

Perampanel in treatment-resistant adult focal epilepsy

“For TRAFE, immediate-release PGB and PER are established as effective to reduce seizure frequency (Level A).” (opens the source at this quote in a new tab)

Mechanism and approved role of perampanel

“Perampanel is a highly selective, non-competitive AMPA receptor antagonist that may exert its antiepileptic effect through selective inhibition of AMPA receptors” (opens the source at this quote in a new tab)
“as add-on treatment for people with focal epilepsy who are 12 years of age and older” (opens the source at this quote in a new tab)

Adjunctive perampanel: pooled efficacy and withdrawal

“Compared with placebo, participants receiving perampanel were more likely to achieve a 50% or greater reduction in seizure frequency (RR 1.67, 95% CI 1.43 to 1.95; 7 trials, 2524 participants; high-certainty evidence).” (opens the source at this quote in a new tab)
“Compared to placebo, perampanel increased seizure freedom (RR 2.50, 95% CI 1.38 to 4.54; 5 trials, 2323 participants; low-certainty evidence)” (opens the source at this quote in a new tab)
“Participants treated with perampanel were more likely to withdraw from treatment due to adverse effects compared to those receiving placebo (RR 2.36, 95% CI 1.59 to 3.51; 7 trials, 2524 participants; low-certainty evidence).” (opens the source at this quote in a new tab)
“Add-on perampanel is effective at reducing seizure frequency and may be effective at maintaining seizure freedom for people with drug-resistant focal epilepsy.” (opens the source at this quote in a new tab)

Adjunctive perampanel: pivotal study 304

“Using this intent-to-treat population over the double-blind phase, the median percent change in seizure frequency was -21.0%, -26.3%, and -34.5% for placebo and perampanel 8 and 12 mg, respectively (p = 0.0261 and p = 0.0158 for 8 and 12 mg vs placebo, respectively).” (opens the source at this quote in a new tab)
“Fifty percent responder rates during the maintenance period were 26.4%, 37.6%, and 36.1%, respectively, for placebo, perampanel 8 mg, and perampanel 12 mg; these differences were not statistically significant for 8 mg (p = 0.0760) or 12 mg (p = 0.0914).” (opens the source at this quote in a new tab)

Adjunctive perampanel: pivotal study 305

“The 50% responder rates (intent-to-treat analysis) were 14.7%, 33.3%, and 33.9%, respectively, for placebo, perampanel 8 mg, and perampanel 12 mg, with significant improvements over placebo for both perampanel 8 mg (p = 0.002) and 12 mg (p < 0.001).” (opens the source at this quote in a new tab)

Adjunctive perampanel: dose-ranging study 306

“Median percent change in seizure frequency-the primary efficacy endpoint-was -10.7%, -13.6%, -23.3%, and -30.8% for placebo, perampanel 2, 4, and 8 mg/day, respectively.” (opens the source at this quote in a new tab)
“The corresponding 50% responder rates were 17.9%, 20.6%, 28.5%, and 34.9%.” (opens the source at this quote in a new tab)