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

Autor: Cerulli Irelli E; Department of Human Neurosciences, Sapienza University, Rome, Italy., Cocchi E; Department of Precision Medicine and Genomics, Department of Medicine, Columbia University, New York, New York, USA., Mostacci B; IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy., Orlando B; Department of Human Neurosciences, Sapienza University, Rome, Italy., Gesche J; Department of Neurology, Odense University Hospital, Odense, Denmark.; Department of Clinical Research, University of Southern Denmark, Odense, Denmark., Caraballo RH; Department of Neurology, Hospital de Pediatría 'Prof. Dr. Juan P. Garrahan', Buenos Aires, Argentina., Lattanzi S; Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy., Strigaro G; Neurology Unit, Department of Translational Medicine, University of Piemonte Orientale, and Azienda Ospedaliero-Universitaria 'Maggiore della Carità', Novara, Italy., Catania C; Department of Human Neurosciences, Sapienza University, Rome, Italy., Pulitano P; Department of Human Neurosciences, Sapienza University, Rome, Italy., Panzini C; Department of Human Neurosciences, Sapienza University, Rome, Italy., Ferlazzo E; Regional Epilepsy Center, 'Bianchi-Melacrino-Morelli' Great Metropolitan Hospital, Reggio Calabria, Italy.; Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy., Pascarella A; Regional Epilepsy Center, 'Bianchi-Melacrino-Morelli' Great Metropolitan Hospital, Reggio Calabria, Italy.; Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy., Casciato S; IRCCS Neuromed, Pozzilli, Italy., Pizzanelli C; Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy., Giuliano L; Section of Neurosciences, Department of Medical and Surgical Sciences and Advanced Technologies 'G.F. Ingrassia', University of Catania, Catania, Italy., Viola V; Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy., Fortunato F; Institute of Neurology, University Magna Graecia, Catanzaro, Italy., Di Gennaro G; IRCCS Neuromed, Pozzilli, Italy., Gambardella A; Institute of Neurology, University Magna Graecia, Catanzaro, Italy., Labate A; Neurophysiopathology and Movement Disorders Clinic, University of Messina, Messina, Italy., Operto FF; Department of Science of Health, School of Medicine, University of Catanzaro, Catanzaro, Italy., Giallonardo AT; Department of Human Neurosciences, Sapienza University, Rome, Italy., Baykan B; Department of Neurology and EMAR Medical Center, Faculty of Medicine, Istanbul University, Istanbul, Turkey., Beier CP; Department of Neurology, Odense University Hospital, Odense, Denmark.; Department of Clinical Research, University of Southern Denmark, Odense, Denmark., Di Bonaventura C; Department of Human Neurosciences, Sapienza University, Rome, Italy.
Jazyk: angličtina
Zdroj: Epilepsia [Epilepsia] 2024 Mar; Vol. 65 (3), pp. e27-e34. Date of Electronic Publication: 2024 Jan 31.
DOI: 10.1111/epi.17892
Abstrakt: 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.
(© 2024 International League Against Epilepsy.)
Databáze: MEDLINE
Externí odkaz: