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01-Dec-2020

Eisai To Present New Seizure Freedom And Real-World Clinical Practice Data Evaluating FYCOMPA® Across Diverse Patient Types At Upcoming AES 2020 Annual Meeting

WOODCLIFF LAKE, N.J., Dec. 1, 2020 /PRNewswire/ -- Eisai Inc. announced today that new data on its antiepileptic drug FYCOMPA® (perampanel) CIII will be presented at the 74th American Epilepsy Society (AES) Annual Meeting to be held from December 4 to December 8, 2020 as a virtual conference. In addition to four independent investigator-initiated studies, Eisai will present 43 posters, underscoring the breadth of data that supports the company's commitment to advance epilepsy research as part of its mission to help provide seizure freedom to a greater number of patients living with epilepsy.

Key data to be presented include:

  • Results from two open-label studies, long-term (52-week) FREEDOM (Study 342) evaluating FYCOMPA monotherapy in newly diagnosed/currently untreated partial-onset seizures (POS) with/without secondarily generalized seizures and FAME (Study 412), evaluating FYCOMPA in patients with secondarily generalized seizures
  • Results from clinical studies (332, 311 and 232) assessing the efficacy and safety of FYCOMPA adjunctive treatment in myoclonic and absence seizures, including a posthoc pooled analysis of adult, adolescent and pediatric patients
  • Real-world clinical practice results of FYCOMPA monotherapy and as an early add-on in epilepsy patients with focal and generalized seizures, in addition to FYCOMPA efficacy and tolerability results in a global pooled analysis

"We are pleased to share new FYCOMPA data evaluating efficacy across a broad spectrum of patients and seizure types, including long-term seizure freedom results and first adjunctive treatment and analyses in pediatric populations at this year's meeting of the American Epilepsy Society," said Lynn Kramer, M.D., Chief Clinical Officer, Neurology Business Group, Eisai. "Eisai is committed to supporting and addressing the needs of patients, caregivers and families affected by epilepsy, and we look forward to providing ongoing research that may help patients achieve seizure freedom."

"The extensive range of FYCOMPA data presented at this year's AES meeting reinforces our commitment to patients and caregivers and highlights the contributions Eisai is making to the epilepsy community," said Ivan Cheung, Chairman, Eisai Inc. and Global President, Neurology Business Group, Eisai Co., Ltd. "While we seek to expand the clinical trial program in neurology, this is an exciting time for Eisai's epilepsy franchise."

In September 2018, FYCOMPA was approved by the FDA for monotherapy and adjunctive use in pediatric patients four years and older for the treatment of POS with or without secondarily generalized seizures. The approval includes both the FYCOMPA tablet and oral suspension formulations. To date, FYCOMPA is approved in 72 countries and has been used to treat more than 300,000 patients worldwide across all indications.

The following are key studies that will be presented by Eisai at this year's AES Annual Meeting:

Note: Posters will be available in the virtual ePoster Hall for the duration of meeting and remain available for 90 days

Poster Name

Session (All Times Eastern)

Long-Term Convulsive Seizure Freedom

Efficacy and Safety of Adjunctive Perampanel for Myoclonic and Absence Seizures:
Post Hoc Pooled Analysis of Adult, Adolescent, and Pediatric Patients in Studies 332, 311, and 232

Christian Brandt, J Ben Renfroe, Leock Y Ngo, Anna Patten, Manoj Malhotra

Poster presentation number: 342
Poster Session: 2
Time: Sunday, December 6
12:00 p.m. to 1:30 p.m. EST

Long-Term Effect of Concomitant Enzyme-Inducing Anti-Seizure Medications (EIASMs) on the
Efficacy and Safety of Adjunctive Perampanel 4 mg/day in Patients with Partial-Onset Seizures in Study 335

Lynn D Kramer, Takuji Nishida, Amitabh Dash, Anna Patten, Leock Y Ngo, Manoj Malhotra

Poster presentation number: 768
Poster Session: 4
Time: Monday, December 7
9:00 a.m. to 10:30 a.m. EST

Sustained Seizure Freedom with Perampanel 4 mg/day Monotherapy in Patients with Newly
Diagnosed/Currently Untreated Recurrent Partial-Onset Seizures: Post Hoc Analysis of Study 342 (FREEDOM)

Yuichi Kubota, Ji Hyun Kim, Sung Chul Lim, Hirotomo Ninomiya, Takamichi Yamamoto,
Anna Patten, Leock Y Ngo, Manoj Malhotra

Poster presentation number: 556
Poster Session: 3
Time: Sunday December 6, 2020
5:15 p.m. – 6:45 p.m. EST

Real-World Use and Quality of Life

PROVE Study 506: Analysis of a Retrospective, Phase IV Study of Perampanel in Real-World
Clinical Care of Patients Based on Study Site Participation in Previous Clinical Trials

Robert T Wechsler, Trevor Resnick, James Wheless, Anna Patten, Alejandro Salah,
Manoj Malhotra

Poster presentation number: 566
Poster Session: 3
Time: Sunday December 6, 2020
5:15 p.m. – 6:45 p.m. EST

Perampanel Monotherapy in Epilepsy Patients with Focal and Generalized Seizures: Real-World Experience

Taoufik Alsaadi, Manuel Toledo, Fernando Ayuga Loro, Eugen Trinka, Tony Wu,
Manoj Malhotra, Leock Y Ngo, Vicente Villanueva

Poster presentation number: 523
Poster Session: 3
Time: Sunday, December 6, 2020
5:15 p.m. – 6:45 p.m. EST

ELEVATE Study 410 initial results: Phase IV study of perampanel as monotherapy or first
adjunctive therapy in patients aged ≥ 4 years with partial-onset or primary generalized
tonic-clonic seizures

Vineet Punia, Pavel Klein, Dinesh Kumar, Alejandro Salah, Manoj Malhotra

Poster presentation number: 766
Poster Session: 4
Time: Monday, December 7, 2020
9:00 a.m. – 10:30 a.m. EST

Pediatric Data

Health-Related Quality of Life (HRQoL) in Paediatric Subjects with Partial Onset Seizures (POS)
or Primary Generalized Tonic Clonic (PGTC) Seizures Receiving Adjunctive Perampanel

Andrew Trigg, Elaine Brohan, Kim Cocks, Amir Tahami, Renee Campbell, Leock Y. Ngo

Poster presentation number: 557
Poster Session: 3
Time: Sunday, December 6, 2020
5:15 p.m. – 6:45 p.m. EST

Adjunctive Treatments

Long-Term Effect of Adjunctive Perampanel on Clinical Global Impression in Pediatric Patients
(Aged 4 to <12 Years) with Partial- Onset or Primary Generalized Tonic-Clonic Seizures in Study 311

Steven Phillips, Andras Fogarasi, Robert Flamini, Anna Patten, Leock Y Ngo

Poster presentation number: 341
Poster Session: 2
Time: Sunday, December 6, 2020
12:00 p.m. – 1:30 p.m. EST

Long-term Seizure Freedom with Adjunctive Perampanel in Pediatric Patients (Aged 4–<12 years)
with Partial-Onset Seizures or Primary Generalized Tonic-Clonic Seizures: Post Hoc Analysis of Study 311

Robert Flamini, Anna Patten, Manoj Malhotra, Leock Y Ngo

Poster presentation number: 564
Poster Session: 3
Time: Sunday, December 6, 2020
5:15 p.m. – 6:45 p.m. EST

Seizure Freedom with Perampanel as First Adjunctive Therapy in Patients with Secondarily Generalized
Seizures in the FAME Study: A Post Hoc Analysis of Low-dose (4 mg and 6 mg) Maintenance Perampanel

Sang Kun Lee, Manoj Malhotra, Dae Won Seo, Sang Ahm Lee, Amitabh Dash, Ji Woong Lee

Poster presentation number: 772
Poster Session: 4
Time: Monday, December 7, 2020
9:00 a.m. – 10:30 a.m. EST

Efficacy and Safety of Perampanel as First Adjunctive Therapy in Patients with Partial-Onset Seizures:
Post Hoc Analysis of the FAME Study by First-Line Antiepileptic Drug and Perampanel Dose

Min Young Kim, Manoj Malhotra, Amitabh Dash, Ji Woong Lee

Poster presentation number: 976
Poster Session: 5
Time: Monday, December 7, 2020
1:30 p.m. – 3:00 p.m. EST

Perampanel in Patients with Secondarily Generalized Seizures: Results from Two Open-label Studies
FREEDOM and FAME

Amitabh Dash, Takamichi Yamamoto, Dong Wook Kim, Manoj Malhotra

Poster presentation number: 767
Poster Session: 4
Time: Monday, December 7, 2020
9:00 a.m. – 10:30 a.m. EST

Open-label Phase II Study to evaluate the Interchangeability of the Novel Intravenous Formulation of
Perampanel from Oral Tablet in Japanese Patients with Epilepsy

Ryosuke Hanaya, Yuichi Kubota, Masahiro Mizobuchi, Koji Iida, Tomonori Ono, Hiromichi Motooka,
Naoki Nakano, Ayataka Fujimoto, Masaki Iwasaki, Masafumi Fukuda, Akihiko Kondo, Katsuhisa Uruno,
Shintaro Yamamuro, Kohei Yamaguchi, Kisaki Onishi, Leock Y Ngo, Yushi Inoue

Poster presentation number: 567
Poster Session: 3
Time: Sunday, December 6, 2020
5:15 p.m. – 6:45 p.m. EST

Adjunctive Perampanel for Primary Generalized Tonic-Clonic Seizures: Time to Seizure Onset in
Phase III Study 332

Alejandro Salah, Anna Patten, Manoj Malhotra

Poster presentation number: 132
Poster Session: 1
Time: Saturday, December 5, 2020
9:00 a.m. – 10:30 a.m. EST

Perampanel as Early Add-on Therapy for Epilepsy Patients with Focal and Generalized Seizures
Treated in Clinical Practice

Estevo Santamarina, Javier Abril-Jaramillo, Xiana Rodriguez- Osorio, Takamichi Yamamoto, Rob McMurray,
Eugen Trinka, Wendyl D'Souza, Vicente Villanueva

Poster presentation number: 302
Poster Session: 2
Time: Sunday, December 6, 2020
12:00 p.m. – 1:30 p.m. EST

Tolerability and Efficacy

Effectiveness and Tolerability of Perampanel in Epilepsy Patients Treated in Routine Clinical Practice: a
Global Pooled Analysis Study

Wendyl D'Souza, Eugen Trinka, Tony Wu, Imad Najm, Manoj Malhotra, Leock Y Ngo, Rob McMurray,
Vicente Villanueva

Poster presentation number: 518
Poster Session: 3
Time: Sunday, December 6, 2020
5:15 p.m. – 6:45 p.m. EST

Perampanel for the Treatment of Focal and Generalized Seizures in Patients with Epilepsy with Tumor
Etiology: Evidence from Clinical Practice

Antonietta Coppola, Shuichi Izumoto, Xiana Rodríguez-Osorio, Tony Wu, Wendyl D'Souza, Marta Maschio,
Samantha Goldman, Vicente Villanueva

Poster presentation number: 299
Poster Session: 2
Time: Sunday, December 6, 2020
12:00 p.m. – 1:30 p.m. EST

Exploring the evidence for broad-spectrum effectiveness of perampanel: Rationale and methods of a
systematic review of clinical data in generalized seizures

Eugen Trinka, Simona Lattanzi, Francesco Brigo

Poster presentation number: 358
Poster Session: 2
Time: Sunday, December 6, 2020
12:00 p.m. – 1:30 p.m. EST

Portions of this release discuss investigational uses for an FDA-approved product. It is not intended to convey conclusions about efficacy or safety. There is no guarantee that any investigational uses of such product will successfully complete clinical development or gain FDA approval.

INDICATION FOR FYCOMPA
FYCOMPA® (perampanel) is indicated in patients with epilepsy aged 4 years and older for partial-onset seizures (POS) with or without secondarily generalized seizures and adjunctive therapy for patients aged 12 years and older for primary generalized tonic-clonic (PGTC) seizures.

IMPORTANT SAFETY INFORMATION FOR FYCOMPA

WARNING: SERIOUS PSYCHIATRIC AND BEHAVIORAL REACTIONS


- Serious or life-threatening psychiatric and behavioral adverse reactions including aggression, hostility, irritability, anger, and homicidal ideation and threats have been reported in patients taking FYCOMPA
- These reactions occurred in patients with and without prior psychiatric history, prior aggressive behavior, or concomitant use of medications associated with hostility and aggression
- Advise patients and caregivers to contact a healthcare provider immediately if any of these reactions or changes in mood, behavior, or personality that are not typical for the patient are observed while taking FYCOMPA or after discontinuing FYCOMPA
- Closely monitor patients particularly during the titration period and at higher doses
- FYCOMPA should be reduced if these symptoms occur and should be discontinued immediately if symptoms are severe or are worsening

SERIOUS PSYCHIATRIC AND BEHAVIORAL REACTIONS
In the partial-onset seizures clinical trials, hostility- and aggression-related adverse reactions occurred in 12% and 20% of patients randomized to receive FYCOMPA at doses of 8 mg and 12 mg per day, respectively, compared to 6% of patients in the placebo group. These effects were dose-related and generally appeared within the first 6 weeks of treatment, although new events continued to be observed through more than 37 weeks. These effects in FYCOMPA-treated patients led to dose reduction, interruption, and discontinuation more frequently than placebo-treated patients. Homicidal ideation and/or threat have also been reported postmarketing in patients treated with FYCOMPA. The combination of alcohol and FYCOMPA significantly worsened mood and increased anger. Patients taking FYCOMPA should avoid the use of alcohol. Patients, their caregivers, and families should be informed that FYCOMPA may increase the risk of psychiatric events. Patients should be monitored during treatment and for at least one month after the last dose of FYCOMPA, and especially when taking higher doses and during the initial few weeks of drug therapy (titration period) or at other times of dose increases. Similar serious psychiatric and behavioral events were observed in the primary generalized tonic-clonic (PGTC) seizure clinical trial.

SUICIDAL BEHAVIOR AND IDEATION
Antiepileptic drugs (AEDs), including FYCOMPA, increase the risk of suicidal thoughts or behavior in patients. Anyone considering prescribing FYCOMPA or any other AED must balance the risk of suicidal thoughts or behavior with the risk of untreated illness. Epilepsy and many other illnesses for which AEDs are prescribed are themselves associated with morbidity and mortality and an increased risk of suicidal thoughts and behavior. Patients, their caregivers, and families should be informed of the risk and advised to monitor and immediately report the emergence or worsening of depression, suicidal thoughts or behavior, thoughts about self-harm and/or any unusual changes in mood or behavior. Should suicidal thoughts and behavior emerge during treatment, consider whether the emergence of these symptoms in any given patient may be related to the illness being treated.

DIZZINESS AND GAIT DISTURBANCE
FYCOMPA caused dose-related increases in events related to dizziness and disturbance in gait or coordination. Dizziness and vertigo were reported in 35% and 47% of patients in the partial-onset seizure trials randomized to receive FYCOMPA at doses of 8 mg and 12 mg per day, respectively, compared to 10% of placebo-treated patients. Gait disturbance related events were reported in 12% and 16% of patients in the partial-onset seizure clinical trials randomized to receive FYCOMPA at doses of 8 mg and 12 mg per day, respectively, compared to 2% of placebo-treated patients. These adverse reactions occurred mostly during the titration phase. These adverse reactions were also observed in the PGTC seizure clinical trial.

SOMNOLENCE AND FATIGUE
FYCOMPA caused dose-dependent increases in somnolence and fatigue-related events. Somnolence was reported in 16% and 18% of patients in the partial-onset seizure trials randomized to receive FYCOMPA at doses of 8 mg and 12 mg per day, respectively, compared to 7% of placebo-treated patients. Fatigue-related events were reported in 12% and 15% of patients in the partial-onset seizure trials randomized to receive FYCOMPA at doses of 8 mg and 12 mg per day, respectively, compared to 5% of placebo-treated patients. These adverse reactions occurred mostly during the titration phase.

These adverse reactions were also observed in the PGTC seizure clinical trial. Patients should be advised against engaging in hazardous activities requiring mental alertness, such as operating motor vehicles or dangerous machinery, until the effect of FYCOMPA is known. Patients should be carefully observed for signs of central nervous system (CNS) depression when FYCOMPA is used with other drugs with sedative properties because of potential additive effects.

FALLS
Falls were reported in 5% and 10% of patients in the partial-onset seizure clinical trials randomized to receive FYCOMPA at doses of 8 mg and 12 mg per day, respectively, compared to 3% of placebo-treated patients.

DRUG REACTION WITH EOSINOPHILIA AND SYSTEMIC SYMPTOMS (DRESS)
DRESS, also known as multiorgan hypersensitivity, has been reported in patients taking AEDs, including FYCOMPA. DRESS may be fatal or life-threatening. DRESS typically, although not exclusively, presents with fever, rash, lymphadenopathy, and/or facial swelling, in association with other organ system involvement. If signs or symptoms are present, immediately evaluate the patient and discontinue FYCOMPA if an alternative etiology for signs or symptoms cannot be established.

WITHDRAWAL OF AEDs
A gradual withdrawal is generally recommended with AEDs to minimize the potential of increased seizure frequency, but if withdrawal is a response to adverse events, prompt withdrawal can be considered.

MOST COMMON ADVERSE REACTIONS
The most common adverse reactions in patients aged 12 years and older receiving FYCOMPA (≥5% and ≥1% higher than placebo) include dizziness, somnolence, fatigue, irritability, falls, nausea, weight gain, vertigo, ataxia, headache, vomiting, contusion, abdominal pain, and anxiety. Adverse reactions in patients aged 4 to <12 years were generally similar to patients aged 12 years and older.

DRUG INTERACTIONS
FYCOMPA may decrease the efficacy of contraceptives containing levonorgestrel. Plasma levels of perampanel were decreased when administered with known moderate and strong CYP3A4 inducers, including, carbamazepine, phenytoin, or oxcarbazepine. Multiple dosing of FYCOMPA 12 mg per day enhanced the effects of alcohol on vigilance and alertness, and increased levels of anger, confusion, and depression. These effects may also be seen when FYCOMPA is used in combination with other CNS depressants. These effects may also be seen when FYCOMPA is used in combination with other CNS depressants.

PREGNANCY AND LACTATION
Physicians are advised to recommend that pregnant patients taking FYCOMPA enroll in the North American Antiepileptic Drug (NAAED) Pregnancy Registry. Caution should be exercised when FYCOMPA is administered to pregnant or nursing women as there are no adequate data on the developmental risk associated with use in pregnant women, and no data on the presence of perampanel in human milk, the effects on the breastfed child, or the effects of the drug on milk production.

HEPATIC AND RENAL IMPAIRMENT
Use in patients with severe hepatic or severe renal impairment is not recommended. Dosage adjustments are recommended in patients with mild or moderate hepatic impairment. Use with caution in patients with moderate renal impairment.

DRUG ABUSE AND DEPENDENCE
FYCOMPA is a Schedule III controlled substance and has the potential to be abused and lead to drug dependence and withdrawal symptoms including anxiety, nervousness, irritability, fatigue, asthenia, mood swings, and insomnia.

Please see full Prescribing Information, including Boxed WARNING.

About FYCOMPA
FYCOMPA is a prescription medicine used in people with epilepsy aged 4 and older alone or with other medicines to treat partial-onset seizures with or without secondarily generalized seizures, and with other medicines to treat primary generalized tonic-clonic seizures for people with epilepsy aged 12 and older.

FYCOMPA, a unique oral medication, is a selective, non-competitive AMPA (alpha-amino-3-hydroxy-5- methyl-4-isoxazolepropionic acid) receptor antagonist. The precise mechanism by which FYCOMPA exerts its antiepileptic effects in humans is unknown. In a pharmacokinetic study, it has been demonstrated that because of its long half-life, a missed dose of FYCOMPA does not significantly impact plasma levels.

FYCOMPA is supplied as 2 mg, 4 mg, 6 mg, 8 mg, 10 mg and 12 mg film-coated tablets, and as a 0.5 mg/mL oral suspension formulation. FYCOMPA has been designated by the U.S. Drug Enforcement Administration as a federally-controlled substance (CIII).

About Epilepsy
Epilepsy is a medical condition that produces seizures affecting a variety of mental and physical functions. Epilepsy is one of the most common neurological disorders, which affects about 3.4 million people in the United States, including 470,000 children. Children with uncontrolled seizures are at greater risk for sudden unexpected death in epilepsy (SUDEP), which is relatively uncommon in childhood, but the risk increases if epilepsy persists into adulthood.

Partial-onset seizures are the most common type of seizure seen in people with epilepsy, accounting for 60 percent of all seizures. Convulsive seizures account for up to 25 percent of all epilepsy, with primary generalized tonic-clonic seizures being one of the most common and severe forms of seizures.

Missed medication doses are the number one cause of breakthrough seizures, which can cause significant injury to patients. People who experience breakthrough seizures have an increased risk of fractures or head injuries, emergency room (ER) visits, and hospitalization, as well as an associated increase in healthcare costs.

About Eisai
Eisai is a leading global research and development-based pharmaceutical company headquartered in Japan, with approximately 10,000 employees worldwide. We define our corporate mission as "giving first thought to patients and their families and to increasing the benefits health care provides," which we call our human health care (hhc) philosophy. We strive to realize our hhc philosophy by delivering innovative products in therapeutic areas with high unmet medical needs, including Oncology and Neurology. In the spirit of hhc, we take that commitment even further by applying our scientific expertise, clinical capabilities and patient insights to discover and develop innovative solutions that help address society's toughest unmet needs, including neglected tropical diseases and the Sustainable Development Goals.

For more information about Eisai, please visit www.eisai.com (for global), us.eisai.com (for U.S.) or www.eisai.co.uk (for U.K.), and connect with us on Twitter (U.S. and global) and LinkedIn (for U.S.).                  

Media Inquiries:

Christopher Vancheri Eisai Inc.
551-305-0050
christopher_vancheri@eisai.com

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Eisai To Present New Seizure Freedom And Real-World Clinical Practice Data Evaluating FYCOMPA® Across Diverse Patient Types At Upcoming AES 2020 Annual Meeting

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Last Updated: 01-Dec-2020