ABSTRACT
Objective:To analyze influencing factors for the clinical efficacy of Perampanel monotherapy in children with focal epilepsy and promote rational clinical use of Perampanel.Methods:Children who were diagnosed with focal epilepsy and treated with Perampanel monotherapy in Wuhan Children′s Hospital, Tongji Medical College, Huazhong University of Science & Technology from June 2021 to August 2022 were included in this retrospective study.Efficacy at 3, 6 and 12 months after treatment was taken as the dependent variable.The gender, age at onset, age at initiation of Perampanel monotherapy, course of disease, weight, body mass index (BMI), seizure frequency, epilepsy syndrome, etiology, previous clinical history, developmental retardation, starting and maintenance doses, blood concentration, CYP3A4 and CYP3A5 gene mutations were taken as the independent variables.The effects of these factors on the efficacy of Perampanel monotherapy were analyzed using the Cox proportional hazards regression.The random forest and decision tree models were used to sequence the significance of the influencing factors and find the optimal cut-point for classification. Results:A total of 43 children (31 boys and 12 girls) were enrolled in this study.The average age at onset was (7.6±2.1) years, and the average age at initiation of Perampanel monotherapy was (7.8±2.7) years.The Cox proportional hazards regression analysis indicated that the greater the BMI, the worse the efficacy of Perampanel ( HR=0.74, 95% CI: 0.55-0.99, P=0.045). Through machine learning, the BMI was found to be a significant covariate affecting the efficacy, and when BMI≥21.8 kg/m 2, the negative effect was more significant. Conclusions:The clinical efficacy of Perampanel monotherapy in children with focal epilepsy is related to BMI.The dose of Perampanel for obese children with epilepsy may need to appropriately increase.
ABSTRACT
Objective To summarize and analyze the difficulties and key points in the measurement of gross α and gross β radioactivity in water based on the results of national measurement capability comparison assessment, and provide the basis and reference for the future work and the development of new local standards. Methods The research team participated in the comparison assessment for measurement of the gross radioactivity in water samples organized by National Institute for Radiological Protection, Chinese Center for Disease Control and Prevention. According to the comparison assessment results and the content in the national standard GB/T 5750.13—2023 (published draft), the steps of spike recovery involved during the measurement were analyzed and discussed. Two different formulas used for spike recovery calculation were analyzed for their impact on the final measurement results. Results When the spike recovery F(derived) derived from the formulas was used for result calculation, the spike recovery ranged as follows: gross α: 63.00%−84.60%, and gross β: 95.0%−99.1%; 3/6 of the comparison results were determined as excellent and 3/6 as pass as a whole (among them, 4 were excellent and 2 were pass for both single gross α assessment items and single gross β assessment items). When the spike recovery F from the GB/T 5750.13—2023 (published draft) was used for result calculation, the spike recovery ranged as follows: gross α: 39.69%−71.57%, and gross β: 90.25%−98.21%; 5/6 of the comparison results were determined as fail and 1/6 as pass (among them, 5 were fail and 1 was pass for single gross α assessment items; 5 were excellent and 1 was pass for single gross β assessment items). When two different formulas were used for spike recovery calculation, there was a significant difference in gross α radioactivity measurement (t = 4.27, P = 0.03 < 0.05), but there was no significant difference in gross β radioactivity measurement (t = 0.667, P = 0.524 > 0.05). Conclusion In the measurement of gross α and gross β radioactivity in water, appropriate reference to the spike recovery has a great influence on the measurement results. Therefore, quality control should be strengthened to further ensure the accuracy of measurement.
ABSTRACT
Perampanel, one of the third-generation antiseizure drugs, can non-competitively bind a-amino-3- hydroxyl-5-methyl-4-isoxazole-propionate receptor. It has been approved for both monotherapy and adjunctive treatment of patients≥4 years old with focal epilepsy (with or without secondary generalized seizures) in China. Researches on treatment of perampanel in special population such as children, the elderly and women have been constantly updated, but summaries on them are lacked recently. This review summarizes the latest clinical studies on the above-mentioned population, providing reasonable basis for clinicians.