Analysis of influencing factors for clinical efficacy of Perampanel monotherapy in children with focal epilepsy based on machine learning
10.3760/cma.j.cn101070-20230610-00469
- VernacularTitle:应用机器学习分析吡仑帕奈单药治疗儿童局灶性癫痫临床疗效的影响因素
- Author:
Jiaqin YI
1
;
Yang WANG
;
Dan SUN
Author Information
1. 华中科技大学同济医学院附属武汉儿童医院神经内科，武汉 430016
- Keywords:
Perampanel;
Focal epilespy;
Monotherapy;
Efficacy;
Influencing factors
- From:
Chinese Journal of Applied Clinical Pediatrics
2024;39(3):198-202
- CountryChina
- Language:Chinese
-
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.
