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Multicenter Study
. 2024 Mar;65(3):e27-e34.
doi: 10.1111/epi.17892. Epub 2024 Jan 31.

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

Emanuele Cerulli Irelli  1 , Enrico Cocchi  2 , Barbara Mostacci  3 , Biagio Orlando  1 , Joanna Gesche  4   5 , Roberto H Caraballo  6 , Simona Lattanzi  7 , Gionata Strigaro  8 , Cecilia Catania  1 , Patrizia Pulitano  1 , Chiara Panzini  1 , Edoardo Ferlazzo  9   10 , Angelo Pascarella  9   10 , Sara Casciato  11 , Chiara Pizzanelli  12 , Loretta Giuliano  13 , Veronica Viola  14 , Francesco Fortunato  15 , Giancarlo Di Gennaro  11 , Antonio Gambardella  15 , Angelo Labate  16 , Francesca F Operto  17 , Anna T Giallonardo  1 , Betul Baykan  18 , Christoph P Beier  4   5 , Carlo Di Bonaventura  1 ; Women With Epilepsy Treatment Options and Research Study Group
Collaborators, Affiliations
Multicenter Study

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

Emanuele Cerulli Irelli et al. Epilepsia. 2024 Mar.

Abstract

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.

Keywords: antiseizure medication; levetiracetam; monotherapy; reproductive age.

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References

REFERENCES

    1. Bjørk MH, Zoega H, Leinonen MK, Cohen JM, Dreier JW, Furu K, et al. Association of Prenatal Exposure to antiseizure medication with risk of autism and intellectual disability [published correction appears in JAMA neurol. 2022 Jul 1;79(7):727]. JAMA Neurol. 2022;79(7):672-681. https://doi.org/10.1001/jamaneurol.2022.1269
    1. Tomson T, Battino D, Bonizzoni E, Craig J, Lindhout D, Perucca E, et al. Comparative risk of major congenital malformations with eight different antiepileptic drugs: a prospective cohort study of the EURAP registry. Lancet Neurol. 2018;17(6):530-538. https://doi.org/10.1016/S1474-4422(18)30107-8
    1. Cerulli Irelli E, Cocchi E, Morano A, Casciato S, Fanella M, Albini M, et al. Valproate impact and sex-dependent seizure remission in patients with idiopathic generalized epilepsy. J Neurol Sci. 2020;415:116940. https://doi.org/10.1016/j.jns.2020.116940
    1. Angus-Leppan H, Shankar R, Cock H. Royal College of psychiatrists intellectual disability section, the United Kingdom learning disability professional senate, and 62 signatories. Valproate, women, and exceptional circumstances. BMJ. 2018;362:k3625. https://doi.org/10.1136/bmj.k3625
    1. Tomson T, Marson A, Boon P, Canevini MP, Covanis A, Gaily E, et al. Valproate in the treatment of epilepsy in girls and women of childbearing potential. Epilepsia. 2015;56(7):1006-1019. https://doi.org/10.1111/epi.13021

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