A Single- and Multiple-Dose Pharmacokinetic Study of Oral Perampanel in Healthy Chinese Subjects

BACKGROUND AND OBJECTIVE: Perampanel is a once-daily oral anti-seizure medication indicated for focal-onset seizures and generalized tonic-clonic seizures. This study investigated the single- and multiple-dose pharmacokinetics of perampanel in healthy Chinese adults. METHODS: Study 052 (NCT03424564) was a phase I, single-center, open-label, parallel-group study. In the single-dose part of the study, subjects received a single oral dose of perampanel 2, 4, or 8 mg. In the multiple-dose part, subjects received once-daily oral perampanel 2 mg on Days 1–7 and 4 mg on Days 8–21. Pharmacokinetic parameters were determined from perampanel plasma concentrations using non-compartmental analysis. Dose proportionality after single doses of perampanel was assessed. Safety and tolerability were evaluated. RESULTS: In the single-dose part (N = 30), median time to reach maximum concentration (t(max)) was 0.75–1.0 h, mean terminal elimination phase half-life (t(½)) was 85.6–122 h, mean maximum observed concentration (C(max)) was 77.9–276 ng/mL, and mean area under the concentration–time curve from time zero to time of the last quantifiable concentration (AUC((0-t))) was 4070–15100 ng·h/mL. Single-dose pharmacokinetics were linear for perampanel 2–8 mg. In the multiple-dose part (N = 12), Day 21 steady-state (4 mg/day) parameters were median time at which the highest drug concentration occurs at steady state (t(ss,max)), 1.25 h; mean t(½), 109 h; mean maximum observed concentration at steady state (C(ss,max)), 453 ng/mL; and mean area under the concentration–time curve over the dosing interval on multiple dosing (AUC((0- τ))), 7540 ng·h/mL. For single- and multiple-dose perampanel, the most common treatment-emergent adverse events were dizziness and somnolence. CONCLUSIONS: Single- and multiple-dose pharmacokinetics of perampanel in healthy Chinese adults revealed rapid perampanel absorption, slow elimination, and a linear relationship with single perampanel doses of 2–8 mg. Findings were consistent with previous studies of perampanel pharmacokinetics in other ethnic/racial populations of healthy subjects. Single and multiple doses of perampanel were generally safe and well tolerated. CLINICAL TRIAL REGISTRATION: NCT03424564; registered February 2018.