Therapeutic levetiracetam monitoring during pregnancy: "mind the gap".
antiepileptic drugs (AEDs)
levetiracetam
pharmacokinetics
pregnancy
therapeutic drug monitoring (TDM)
Journal
Therapeutic advances in chronic disease
ISSN: 2040-6223
Titre abrégé: Ther Adv Chronic Dis
Pays: United States
ID NLM: 101532140
Informations de publication
Date de publication:
2019
2019
Historique:
received:
30
08
2018
accepted:
26
04
2019
entrez:
14
6
2019
pubmed:
14
6
2019
medline:
14
6
2019
Statut:
epublish
Résumé
Epilepsy is one of the most common chronic neurological conditions and its treatment during pregnancy is challenging. Levetiracetam (LEV) is an antiepileptic medication frequently used during pregnancy. Only a few small studies have been published on LEV monitoring during pregnancy, demonstrating decreased serum LEV levels during the first and second trimester; however, the most significant decrease was observed during the third trimester of pregnancy. In this study we aimed to evaluate LEV pharmacokinetics during different stages of pregnancy. We followed up and monitored serum levels of pregnant women treated with LEV for epilepsy. Fifty-nine women with 66 pregnancies during the study period were included. The lowest raw LEV serum concentrations were observed during the first trimester. Compared with the pre-pregnancy period, raw serum concentration was lower by 5.76 mg/L [95% confidence interval (CI) (2.78, 8.75), Raw LEV serum levels tend to decrease during pregnancy, mainly during the first trimester contrary to previous reports. Monitoring of LEV serum levels is essential upon planning pregnancy and thereafter if pre-pregnancy LEV levels are to be maintained. However, more studies are needed to assess the correlation with clinical outcome.
Sections du résumé
BACKGROUND
BACKGROUND
Epilepsy is one of the most common chronic neurological conditions and its treatment during pregnancy is challenging. Levetiracetam (LEV) is an antiepileptic medication frequently used during pregnancy. Only a few small studies have been published on LEV monitoring during pregnancy, demonstrating decreased serum LEV levels during the first and second trimester; however, the most significant decrease was observed during the third trimester of pregnancy. In this study we aimed to evaluate LEV pharmacokinetics during different stages of pregnancy.
METHODS
METHODS
We followed up and monitored serum levels of pregnant women treated with LEV for epilepsy.
RESULTS
RESULTS
Fifty-nine women with 66 pregnancies during the study period were included. The lowest raw LEV serum concentrations were observed during the first trimester. Compared with the pre-pregnancy period, raw serum concentration was lower by 5.76 mg/L [95% confidence interval (CI) (2.78, 8.75),
CONCLUSIONS
CONCLUSIONS
Raw LEV serum levels tend to decrease during pregnancy, mainly during the first trimester contrary to previous reports. Monitoring of LEV serum levels is essential upon planning pregnancy and thereafter if pre-pregnancy LEV levels are to be maintained. However, more studies are needed to assess the correlation with clinical outcome.
Identifiants
pubmed: 31191874
doi: 10.1177/2040622319851652
pii: 10.1177_2040622319851652
pmc: PMC6540481
doi:
Types de publication
Journal Article
Langues
eng
Pagination
2040622319851652Déclaration de conflit d'intérêts
Conflict of interest statement: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
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