Topiramate ban in women of childbearing potential with idiopathic generalized epilepsy: Does effectiveness offset the teratogenic risks?

被引：2

作者：

Irelli, Emanuele Cerulli ^{[1
]}

Cocchi, Enrico ^{[2
]}

Mostacci, Barbara ^{[3
]}

Orlando, Biagio ^{[1
]}

Gesche, Joanna ^{[4
,5
]}

Caraballo, Roberto H. ^{[6
]}

Lattanzi, Simona ^{[7
]}

Strigaro, Gionata ^{[8
,9
]}

Catania, Cecilia ^{[1
]}

Pulitano, Patrizia ^{[1
]}

Panzini, Chiara ^{[1
]}

Ferlazzo, Edoardo ^{[10
,11
]}

Pascarella, Angelo ^{[10
,11
]}

Casciato, Sara ^{[12
]}

Pizzanelli, Chiara ^{[13
]}

Giuliano, Loretta ^{[14
]}

Viola, Veronica ^{[15
]}

Fortunato, Francesco ^{[16
]}

Di Gennaro, Giancarlo ^{[12
]}

Gambardella, Antonio ^{[16
]}

Labate, Angelo ^{[17
]}

Operto, Francesca F. ^{[18
]}

Giallonardo, Anna T. ^{[1
]}

Baykan, Betul ^{[19
,20
]}

Beier, Christoph P. ^{[4
,5
]}

Di Bonaventura, Carlo ^{[1
,21
]}

机构：

[1] Sapienza Univ, Dept Human Neurosci, Rome, Italy

[2] Columbia Univ, Dept Precis Med & Genom, Dept Med, New York, NY USA

[3] IRCCS Ist Sci Neurolog Bologna, Bologna, Italy

[4] Odense Univ Hosp, Dept Neurol, Odense, Denmark

[5] Univ Southern Denmark, Dept Clin Res, Odense, Denmark

[6] Hosp Pediat Prof Dr Juan P Garrahan, Dept Neurol, Buenos Aires, Argentina

[7] Marche Polytech Univ, Dept Expt & Clin Med, Neurol Clin, Ancona, Italy

[8] Univ Piemonte Orientale, Dept Translat Med, Neurol Unit, Novara, Italy

[9] Azienda Osped Univ Maggiore Carita, Novara, Italy

[10] Bianchi Melacrino Morelli Great Metropolitan Hosp, Reg Epilepsy Ctr, Reggio Di Calabria, Italy

[11] Magna Graecia Univ Catanzaro, Dept Med & Surg Sci, Catanzaro, Italy

[12] IRCCS Neuromed, Pozzilli, Italy

[13] Univ Pisa, Dept Clin & Expt Med, Neurol Unit, Pisa, Italy

[14] Univ Catania, Dept Med & Surg Sci & Adv Technol GF Ingrassia, Sect Neurosci, Catania, Italy

[15] Univ Bologna, Dept Biomed & Neuromotor Sci DIBINEM, Bologna, Italy

[16] Magna Graecia Univ Catanzaro, Inst Neurol, Catanzaro, Italy

[17] Univ Messina, Neurophysiopathol & Movement Disorders Clin, Messina, Italy

[18] Univ Catanzaro, Sch Med, Dept Sci Hlth, Catanzaro, Italy

[19] Istanbul Univ, Fac Med, Dept Neurol, Istanbul, Turkiye

[20] Istanbul Univ, Fac Med, EMAR Med Ctr, Istanbul, Turkiye

[21] Sapienza Univ Rome, Dept Human Neurosci, Viale Univ 30, IT-00185 Rome, Italy

来源：

EPILEPSIA | 2024年 / 65卷 / 03期

关键词：

antiseizure medication; levetiracetam; monotherapy; reproductive age; PREGNANCY; VALPROATE;

D O I：

10.1111/epi.17892

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Regulatory agencies have recently discouraged the prescription of topiramate (TPM) to women of childbearing potential with epilepsy due to growing evidence of the teratogenic and neurodevelopmental risks associated with its use during pregnancy. It remains, however, unclear whether the use of TPM in this population can be supported to some extent by its high effectiveness. In this multicenter, retrospective, cohort study performed at 22 epilepsy centers, we investigated the comparative effectiveness of TPM and levetiracetam (LEV) given as first-line antiseizure medication in a cohort of women of childbearing potential with idiopathic generalized epilepsy (IGE). A total of 336 participants were included, of whom 24 (7.1%) received TPM and 312 (92.9%) LEV. Women treated with TPM had significantly higher risks of treatment failure and treatment withdrawal and were less likely to achieve seizure freedom at 12 months compared to women treated with LEV. In conclusion, this study highlighted a low tendency among clinicians to use TPM in women of childbearing potential with IGE, anticipating the recently released restrictions on its use. Furthermore, the available data on effectiveness do not appear to support the use of TPM in this population.

引用

页码：e27 / e34

页数：8

共 3 条

[1] Doing without valproate in women of childbearing potential with idiopathic generalized epilepsy: Implications on seizure outcome
Irelli, Emanuele Cerulli
Morano, Alessandra
Cocchi, Enrico
Casciato, Sara
Fanella, Martina
Albini, Mariarita
Avorio, Federica
Basili, Luca M.
Fisco, Giacomo
Barone, Francesca A.
Mascia, Addolarata
D'Aniello, Alfredo
Manfredi, Mario
Fattouch, Jinane
Quarato, Pierpaolo
Giallonardo, Anna Teresa
Di Gennaro, Giancarlo
Di Bonaventura, Carlo
EPILEPSIA, 2020, 61 (01) : 107 - 114
[2] TREATMENT OF EPILEPSY IN WOMEN OF CHILDBEARING AGE - PATIENTS OPINION OF TERATOGENIC POTENTIAL OF VALPROATE
PHILBERT, A
PEDERSEN, B
ACTA NEUROLOGICA SCANDINAVICA, 1983, 67 : 35 - 38
[3] Alternatives to valproate in girls and women of childbearing potential with Idiopathic Generalized Epilepsies: state of the art and guidance for the clinician proposed by the Epilepsy and Gender Commission of the Italian League Against Epilepsy (LICE)
Mostacci, Barbara
Ranzato, Federica
Giuliano, Loretta
La Neve, Angela
Aguglia, Umberto
Bilo, Leonilda
Durante, Vania
Ermio, Caterina
Monti, Giulia
Zambrelli, Elena
Lodi, Monica Anna Maria
Galimberti, Carlo Andrea
SEIZURE-EUROPEAN JOURNAL OF EPILEPSY, 2021, 85 : 26 - 38

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