Sex differences in side effects of antiseizure medications in pediatric patients with epilepsy: A systematic review.

Autor: Giuliano L; Department of Medical, Surgical Sciences and Advanced Technologies G.F. Ingrassia, Section of Neurosciences, University of Catania, Italy., Vecchio C; Department of Medical, Surgical Sciences and Advanced Technologies G.F. Ingrassia, Section of Neurosciences, University of Catania, Italy., Mastrangelo V; Neurology Unit, Rimini 'Infermi' Hospital, AUSL Romagna, Viale Luigi Settembrini, 2, Rimini, RN 47923, Italy. Electronic address: vincenzo.mastrangel2@studio.unibo.it., Durante V; Neurology Unit, 'A. Perrino' Hospital, Brindisi, Italy., Zambrelli E; Epilepsy Center, Sleep Medicine Center, Childhood and Adolescence Neuropsychiatry Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan, Italy., Cantalupo G; U.O.C. di Neuropsichiatria Infantile, Dipartimento ad Attività Integrata Materno Infantile - AOUI di Verona, Full Member of the ERN EpiCARE, Verona, Italy; Department of Surgical Sciences, Child Neuropsychiatry, Dentistry, Gynecology and Pediatrics, University of Verona, Italy; Centro Ricerca per le Epilessie in età Pediatrica (CREP), Azienda Ospedaliera Universitaria di Verona, Verona, Italy., La Neve A; Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Bari, Italy., Ermio C; Department of Neuroscience, 'S. Giovanni Paolo II' Hospital, Lamezia Terme, Catanzaro, Italy., Mostacci B; IRCCS Istituto delle Scienze Neurologiche di Bologna, Full Member of the ERN EpiCARE, Bologna, Italy.
Jazyk: angličtina
Zdroj: Seizure [Seizure] 2022 Nov; Vol. 102, pp. 6-13. Date of Electronic Publication: 2022 Sep 17.
DOI: 10.1016/j.seizure.2022.09.013
Abstrakt: Purpose: To perform a systematic review searching for differences in the side effects of antiseizure medications (ASMs) with respect to sex in pediatric patients with epilepsy.
Methods: We carried out a comprehensive literature search of the PubMed database and all results up to April 2020 were included. Titles, abstracts, and full texts of the articles were screened by two independent reviewers. We included all studies evaluating the side effects of ASMs in patients with epilepsy younger than 18 years, with reference to the two sexes. Studies on ASMs used for indications other than epilepsy were excluded.
Results: A total of 5164 studies were identified. Sixty-seven studies were finally included, 5 of them also including adult patients in the sample. Sixteen studies revealed sex-related differences in side effects of ASMs, disclosing a higher frequency of general side effects in girls: a higher risk of overweight, hyperammonaemia, high leptin levels, and carnitine deficiency in girls on valproic acid; a lower height increase, an increased risk of weight loss, the anecdotical occurrence of acute psychosis in girls on topiramate; a higher risk of retinal toxicity in boys on vigabatrin.
Conclusion: The effect of sex on susceptibility to side effects of ASMs is poorly investigated with sparse results, and it could be underestimated. The findings of our study point to the presence of sex differences which should be thoroughly investigated to be confirmed, highlighting the need for a systematic evaluation of sex as a determinant variable influencing the response to medications in clinical research.
Competing Interests: Declaration of Competing Interest Dr. Giuliano received honoraria as a speaker and or congress and travel expenses from EISAI and UCB. Dr. Zambrelli received honoraria as congress and travel expenses from Lusofarmaco. Dr. Cantalupo received speaker honoraria from "GW Pharmaceuticals" and from "Grupo de Trabajo de Epilepsia de la Sociedad Española de Neurología Pediátrica (SENEP)". Dr. La Neve has received speaker's or consultancy fees from Eisai, Mylan, Sanofi, Bial, GW, UCB Pharma, Arvelle Therapeutics, Angelini Pharma and Neuraxpharma. Dr. Mostacci received honoraria as a speaker and or congress and travel expenses from EISAI, Sanofi, GW Pharma. Dr. Vecchio, Dr. Mastrangelo, Dr. Durante, Dr. Ermio have no conflicts of interest to declare.
(Copyright © 2022. Published by Elsevier Ltd.)
Databáze: MEDLINE
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