Efficacy and safety of perampanel in epilepsy: A systematic review and meta-analysis of randomised controlled trials

•This systematic review reports significant reduction in seizures and a potential dose-based increase in discontinuations due to TEAE.•When compared with placebo, both 8 mg and 12 mg doses of perampanel showed similar efficacy in seizure control.•A higher risk of treatment discontinuation was found among 12 mg users than among 8 mg users.•The most reported TEAEs were non-threatening, with the potential possibility of rare but serious adverse psychological outcomes.•Further comparative effectiveness trials – as well as longitudinal follow-up observational studies – are needed to decide on the optimal doses for epilepsy management with perampanel.