Declining malformation rates with changed antiepileptic drug prescribing: An observational study.

Abnormalities, Drug-Induced / epidemiology Adolescent Adult Anticonvulsants / adverse effects Epilepsy / drug therapy Female Humans Internationality Middle Aged Practice Patterns, Physicians' / statistics & numerical data Pregnancy Prevalence Prospective Studies Registries / statistics & numerical data Young Adult

Journal

Neurology
ISSN: 1526-632X
Titre abrégé: Neurology
Pays: United States
ID NLM: 0401060

Informations de publication

Date de publication:
27 08 2019
Historique:
received: 20 12 2018
accepted: 01 04 2019
pubmed: 9 8 2019
medline: 6 2 2020
entrez: 9 8 2019
Statut: ppublish

Résumé

Changes in prescribing patterns of antiepileptic drugs (AEDs) in pregnant women with epilepsy would be expected to affect the risk of major congenital malformations (MCMs). To test this hypothesis, we analyzed data from an international pregnancy registry (EURAP). EURAP is an observational prospective cohort study designed to determine the risk of MCMs after prenatal exposure to AEDs. The Cochrane-Armitage linear trend analysis was used to assess changes in AED treatment, prevalence of MCMs, and occurrence of generalized tonic-clonic seizures (GTCs) over 3 time periods: 2000-2005 (n = 4,760), 2006-2009 (n = 3,599), and 2010-2013 (n = 2,949). There were pronounced changes in the use of specific AEDs over time, with a decrease in the use of valproic acid and carbamazepine and an increase in the use of lamotrigine and levetiracetam. The prevalence of MCMs with monotherapy exposure decreased from 6.0% in 2000-2005 to 4.4% in 2010-2013. The change over time in MCM frequency after monotherapy exposure showed a significant linear trend in the crude analysis ( There have been major changes in AED prescription patterns over the years covered by the study. In parallel, we observed a significant 27% decrease in the prevalence of MCMs. The results of adjusting the trend analysis for MCMs for changes in AED treatment suggest that changes in prescription patterns played a major role in the reduction of teratogenic events.

Identifiants

DOI: 10.1212/WNL.0000000000008001 PMID: 31391249
pubmed: 31391249
pii: WNL.0000000000008001
doi: 10.1212/WNL.0000000000008001
doi:

Substances chimiques

Anticonvulsants 0

Types de publication

Journal Article Observational Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e831-e840

Investigateurs

Silvia Kochen (S)
Gerhard Luef (G)
Eugene van Puijenbroek (E)
Alejandro De Marinis (A)
Jana Zarubova (J)
Reetta Kälviäinen (R)
Bettina Schmitz (B)
Sofia Kasradze (S)
Miri Neufeld (M)
Luigi Maria Specchio (LM)
Hideyuki Ohtani (H)
Gordana Kiteva-Trencevska (G)
Silje Alvestad (S)
Leonor Cabral-Lim (L)
Maja Milovanović (M)
Vladimír Safcák (V)
Boštjan Čebular (B)
Meritxell Martinez Ferri (MM)
Barbara Tettenborn (B)
Martin Kurthen (M)
Hsiang-Yu Yu (HY)
Aline Russell (A)
Chiara Pantaleoni (C)
Francesca Faravelli (F)
Elisabeth Robert-Gnansia (E)
Natalia Bohorquez Morera (NB)
Stephanie Hödl (S)
Germaine Kenou Van Rijckevorssel (GK)
Hana Krijtová (H)
Renata Listonova (R)
Iva Marečková (I)
Petr Bušek (P)
Gisela Rytířová (G)
Jakob Christensen (J)
Birthe Pedersen (B)
Stefan Juhl (S)
Pia Gellert (P)
Uden Navn (U)
Noemi Becser Andersen (NB)
Vaiva Petrenaite (V)
Jens Arentsen (J)
Birgitte Forsom Sondal (BF)
Ismael Barzinji (I)
Katarzyna Miesczanleh (K)
Lone Rodam (L)
Elias Zakharia (E)
Morteza Zarifi-Oskoie (M)
Mogens Worm (M)
Elsebeth Bruun Christensen (EB)
Reina Roivainen (R)
Terttu Heikinheimo-Connell (T)
Anna Maija Saukkonen (AM)
Aileen McGonigal (A)
Dieter Dennig (D)
Tim Hendgen (T)
Bernhard Steinhoff (B)
Birgit Müffelmann (B)
Judith Osseforth (J)
E Kluck (E)
Odo Hildenhagen (O)
Theresa Lasch (T)
Astrid Carius (A)
Elena Zambrelli (E)
Albertina Franza (A)
Maria Paola Canevini (MP)
Katherine Turner (K)
Michela Cecconi (M)
Aldo Paggi (A)
Andrea Ortenzi (A)
Claudia Cagnetti (C)
Nicoletta Foschi (N)
Antonio Gambardella (A)
Angelo Labate (A)
Giovanni De Maria (G)
Luisa Antonini (L)
Laura Broglio (L)
Daniela Marino (D)
Raffaele Rocchi (R)
Paolo Tinuper (P)
Barbara Mostacci (B)
Francesca Bisulli (F)
Giovanni Ambrosetto (G)
Marina Trivisano (M)
Alessandra Pistelli (A)
Pietro Pignatta (P)
Yushi Inoue (Y)
Kiyohito Terada (K)
Katsuyuki Fukushima (K)
Masaaki Kato (M)
Masahiro Mizobuchi (M)
Karl Otto Nakken (KO)
Rasmus Lossius (R)
Erik Tauboll (E)
Leif Gjerstad (L)
Alma Sikiric (A)
Torleiv Svendsen (T)
Anette Huuse Farmen (AH)
Christian Samsonsen (C)
Claus Albretsen (C)
Dag Aurlien (D)
Eylert Brodtkorb (E)
Ineke Hogenesch (I)
Janne Marit Ertresvåg (JM)
Katrine Haggag (K)
Brenda Diputado (B)
Isabel Pires (I)
Martin J Brodie (MJ)
Jesús Antonio Riuz Gimenez (JA)
Eliana Pastor (E)
David Sopelana Garay (DS)
Juan Luis Becerra Cuñat (JL)
Maria Dolores Castro Vilanova (MD)
Iñigo Garamendi Ruiz (IG)
Toni Escartin (T)
Gemma Sansa Fayos (GS)
Lisa Gordon (L)
Eva Kumlien (E)
Peter Mattsson (P)
Imad Halawa (I)
Anders Lundgren (A)
Maria Strandberg (M)
Anders Nilsson (A)
Hans Lindsten (H)
Helena Gauffin (H)
Kristina Malmgren (K)
Zarouhi Hertz (Z)
Dominique Flügel (D)
Bernhard Oehl (B)
T-Y Chang (TY)

Commentaires et corrections

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Informations de copyright

© 2019 American Academy of Neurology.

Auteurs

Torbjörn Tomson (T)

From the Department of Clinical Neuroscience (T.T.), Karolinska Institutet; Department of Neurology (T.T.), Karolinska University Hospital, Stockholm, Sweden; Epilepsy Center, Department of Neurophysiology and Experimental Epileptology (D.B.), Fondazione IRCCS Istituto Neurologico Carlo Besta; Department of Clinical Science and Community (E.B.), Section of Medical Statistics, Biometry and Epidemiology "G.A. Maccacaro," Faculty of Medicine and Surgery, University of Milan, Italy; Belfast Health and Social Care Trust (J.C.), Belfast, UK; Department of Genetics (D.L.), University Medical Center Utrecht; Stichting Epilepsie Instellingen Nederland (SEIN) (D.L.), Heemstede, the Netherlands; Department of Internal Medicine and Therapeutics (E.P.), University of Pavia; Clinical Trial Center (E.P.), IRCCS Mondino Foundation, Pavia, Italy; The Epilepsy Clinic, Department of Neurology (A.S.), Rigshospitalet-Blegdamsvej, University State Hospital, Copenhagen, Denmark; Department of Neurology (S.V.T.), Sree Chitra Tirunal Institute of Medical Sciences and Technology, Trivandrum, Kerala State, India; Departments of Medicine and Neurology (F.V.), University of Melbourne and Monash University; and Royal Melbourne Hospital (F.V.), Australia. torbjorn.tomson@sll.se.

Dina Battino (D)

From the Department of Clinical Neuroscience (T.T.), Karolinska Institutet; Department of Neurology (T.T.), Karolinska University Hospital, Stockholm, Sweden; Epilepsy Center, Department of Neurophysiology and Experimental Epileptology (D.B.), Fondazione IRCCS Istituto Neurologico Carlo Besta; Department of Clinical Science and Community (E.B.), Section of Medical Statistics, Biometry and Epidemiology "G.A. Maccacaro," Faculty of Medicine and Surgery, University of Milan, Italy; Belfast Health and Social Care Trust (J.C.), Belfast, UK; Department of Genetics (D.L.), University Medical Center Utrecht; Stichting Epilepsie Instellingen Nederland (SEIN) (D.L.), Heemstede, the Netherlands; Department of Internal Medicine and Therapeutics (E.P.), University of Pavia; Clinical Trial Center (E.P.), IRCCS Mondino Foundation, Pavia, Italy; The Epilepsy Clinic, Department of Neurology (A.S.), Rigshospitalet-Blegdamsvej, University State Hospital, Copenhagen, Denmark; Department of Neurology (S.V.T.), Sree Chitra Tirunal Institute of Medical Sciences and Technology, Trivandrum, Kerala State, India; Departments of Medicine and Neurology (F.V.), University of Melbourne and Monash University; and Royal Melbourne Hospital (F.V.), Australia.

Erminio Bonizzoni (E)

From the Department of Clinical Neuroscience (T.T.), Karolinska Institutet; Department of Neurology (T.T.), Karolinska University Hospital, Stockholm, Sweden; Epilepsy Center, Department of Neurophysiology and Experimental Epileptology (D.B.), Fondazione IRCCS Istituto Neurologico Carlo Besta; Department of Clinical Science and Community (E.B.), Section of Medical Statistics, Biometry and Epidemiology "G.A. Maccacaro," Faculty of Medicine and Surgery, University of Milan, Italy; Belfast Health and Social Care Trust (J.C.), Belfast, UK; Department of Genetics (D.L.), University Medical Center Utrecht; Stichting Epilepsie Instellingen Nederland (SEIN) (D.L.), Heemstede, the Netherlands; Department of Internal Medicine and Therapeutics (E.P.), University of Pavia; Clinical Trial Center (E.P.), IRCCS Mondino Foundation, Pavia, Italy; The Epilepsy Clinic, Department of Neurology (A.S.), Rigshospitalet-Blegdamsvej, University State Hospital, Copenhagen, Denmark; Department of Neurology (S.V.T.), Sree Chitra Tirunal Institute of Medical Sciences and Technology, Trivandrum, Kerala State, India; Departments of Medicine and Neurology (F.V.), University of Melbourne and Monash University; and Royal Melbourne Hospital (F.V.), Australia.

John Craig (J)

From the Department of Clinical Neuroscience (T.T.), Karolinska Institutet; Department of Neurology (T.T.), Karolinska University Hospital, Stockholm, Sweden; Epilepsy Center, Department of Neurophysiology and Experimental Epileptology (D.B.), Fondazione IRCCS Istituto Neurologico Carlo Besta; Department of Clinical Science and Community (E.B.), Section of Medical Statistics, Biometry and Epidemiology "G.A. Maccacaro," Faculty of Medicine and Surgery, University of Milan, Italy; Belfast Health and Social Care Trust (J.C.), Belfast, UK; Department of Genetics (D.L.), University Medical Center Utrecht; Stichting Epilepsie Instellingen Nederland (SEIN) (D.L.), Heemstede, the Netherlands; Department of Internal Medicine and Therapeutics (E.P.), University of Pavia; Clinical Trial Center (E.P.), IRCCS Mondino Foundation, Pavia, Italy; The Epilepsy Clinic, Department of Neurology (A.S.), Rigshospitalet-Blegdamsvej, University State Hospital, Copenhagen, Denmark; Department of Neurology (S.V.T.), Sree Chitra Tirunal Institute of Medical Sciences and Technology, Trivandrum, Kerala State, India; Departments of Medicine and Neurology (F.V.), University of Melbourne and Monash University; and Royal Melbourne Hospital (F.V.), Australia.

Dick Lindhout (D)

From the Department of Clinical Neuroscience (T.T.), Karolinska Institutet; Department of Neurology (T.T.), Karolinska University Hospital, Stockholm, Sweden; Epilepsy Center, Department of Neurophysiology and Experimental Epileptology (D.B.), Fondazione IRCCS Istituto Neurologico Carlo Besta; Department of Clinical Science and Community (E.B.), Section of Medical Statistics, Biometry and Epidemiology "G.A. Maccacaro," Faculty of Medicine and Surgery, University of Milan, Italy; Belfast Health and Social Care Trust (J.C.), Belfast, UK; Department of Genetics (D.L.), University Medical Center Utrecht; Stichting Epilepsie Instellingen Nederland (SEIN) (D.L.), Heemstede, the Netherlands; Department of Internal Medicine and Therapeutics (E.P.), University of Pavia; Clinical Trial Center (E.P.), IRCCS Mondino Foundation, Pavia, Italy; The Epilepsy Clinic, Department of Neurology (A.S.), Rigshospitalet-Blegdamsvej, University State Hospital, Copenhagen, Denmark; Department of Neurology (S.V.T.), Sree Chitra Tirunal Institute of Medical Sciences and Technology, Trivandrum, Kerala State, India; Departments of Medicine and Neurology (F.V.), University of Melbourne and Monash University; and Royal Melbourne Hospital (F.V.), Australia.

Emilio Perucca (E)

From the Department of Clinical Neuroscience (T.T.), Karolinska Institutet; Department of Neurology (T.T.), Karolinska University Hospital, Stockholm, Sweden; Epilepsy Center, Department of Neurophysiology and Experimental Epileptology (D.B.), Fondazione IRCCS Istituto Neurologico Carlo Besta; Department of Clinical Science and Community (E.B.), Section of Medical Statistics, Biometry and Epidemiology "G.A. Maccacaro," Faculty of Medicine and Surgery, University of Milan, Italy; Belfast Health and Social Care Trust (J.C.), Belfast, UK; Department of Genetics (D.L.), University Medical Center Utrecht; Stichting Epilepsie Instellingen Nederland (SEIN) (D.L.), Heemstede, the Netherlands; Department of Internal Medicine and Therapeutics (E.P.), University of Pavia; Clinical Trial Center (E.P.), IRCCS Mondino Foundation, Pavia, Italy; The Epilepsy Clinic, Department of Neurology (A.S.), Rigshospitalet-Blegdamsvej, University State Hospital, Copenhagen, Denmark; Department of Neurology (S.V.T.), Sree Chitra Tirunal Institute of Medical Sciences and Technology, Trivandrum, Kerala State, India; Departments of Medicine and Neurology (F.V.), University of Melbourne and Monash University; and Royal Melbourne Hospital (F.V.), Australia.

Anne Sabers (A)

From the Department of Clinical Neuroscience (T.T.), Karolinska Institutet; Department of Neurology (T.T.), Karolinska University Hospital, Stockholm, Sweden; Epilepsy Center, Department of Neurophysiology and Experimental Epileptology (D.B.), Fondazione IRCCS Istituto Neurologico Carlo Besta; Department of Clinical Science and Community (E.B.), Section of Medical Statistics, Biometry and Epidemiology "G.A. Maccacaro," Faculty of Medicine and Surgery, University of Milan, Italy; Belfast Health and Social Care Trust (J.C.), Belfast, UK; Department of Genetics (D.L.), University Medical Center Utrecht; Stichting Epilepsie Instellingen Nederland (SEIN) (D.L.), Heemstede, the Netherlands; Department of Internal Medicine and Therapeutics (E.P.), University of Pavia; Clinical Trial Center (E.P.), IRCCS Mondino Foundation, Pavia, Italy; The Epilepsy Clinic, Department of Neurology (A.S.), Rigshospitalet-Blegdamsvej, University State Hospital, Copenhagen, Denmark; Department of Neurology (S.V.T.), Sree Chitra Tirunal Institute of Medical Sciences and Technology, Trivandrum, Kerala State, India; Departments of Medicine and Neurology (F.V.), University of Melbourne and Monash University; and Royal Melbourne Hospital (F.V.), Australia.

Sanjeev V Thomas (SV)

From the Department of Clinical Neuroscience (T.T.), Karolinska Institutet; Department of Neurology (T.T.), Karolinska University Hospital, Stockholm, Sweden; Epilepsy Center, Department of Neurophysiology and Experimental Epileptology (D.B.), Fondazione IRCCS Istituto Neurologico Carlo Besta; Department of Clinical Science and Community (E.B.), Section of Medical Statistics, Biometry and Epidemiology "G.A. Maccacaro," Faculty of Medicine and Surgery, University of Milan, Italy; Belfast Health and Social Care Trust (J.C.), Belfast, UK; Department of Genetics (D.L.), University Medical Center Utrecht; Stichting Epilepsie Instellingen Nederland (SEIN) (D.L.), Heemstede, the Netherlands; Department of Internal Medicine and Therapeutics (E.P.), University of Pavia; Clinical Trial Center (E.P.), IRCCS Mondino Foundation, Pavia, Italy; The Epilepsy Clinic, Department of Neurology (A.S.), Rigshospitalet-Blegdamsvej, University State Hospital, Copenhagen, Denmark; Department of Neurology (S.V.T.), Sree Chitra Tirunal Institute of Medical Sciences and Technology, Trivandrum, Kerala State, India; Departments of Medicine and Neurology (F.V.), University of Melbourne and Monash University; and Royal Melbourne Hospital (F.V.), Australia.

Frank Vajda (F)

From the Department of Clinical Neuroscience (T.T.), Karolinska Institutet; Department of Neurology (T.T.), Karolinska University Hospital, Stockholm, Sweden; Epilepsy Center, Department of Neurophysiology and Experimental Epileptology (D.B.), Fondazione IRCCS Istituto Neurologico Carlo Besta; Department of Clinical Science and Community (E.B.), Section of Medical Statistics, Biometry and Epidemiology "G.A. Maccacaro," Faculty of Medicine and Surgery, University of Milan, Italy; Belfast Health and Social Care Trust (J.C.), Belfast, UK; Department of Genetics (D.L.), University Medical Center Utrecht; Stichting Epilepsie Instellingen Nederland (SEIN) (D.L.), Heemstede, the Netherlands; Department of Internal Medicine and Therapeutics (E.P.), University of Pavia; Clinical Trial Center (E.P.), IRCCS Mondino Foundation, Pavia, Italy; The Epilepsy Clinic, Department of Neurology (A.S.), Rigshospitalet-Blegdamsvej, University State Hospital, Copenhagen, Denmark; Department of Neurology (S.V.T.), Sree Chitra Tirunal Institute of Medical Sciences and Technology, Trivandrum, Kerala State, India; Departments of Medicine and Neurology (F.V.), University of Melbourne and Monash University; and Royal Melbourne Hospital (F.V.), Australia.

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Classifications MeSH

questionsmedicales.fr › Malformations et maladies congénitales, héréditaires et néonatales › Malformations › Malformations dues aux médicaments et aux drogues › Declining malformation rates with changed...
questionsmedicales.fr › Personnes › Tranches d'âge › Adolescent › Declining malformation rates with changed...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Declining malformation rates with changed...
questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Agents du système nerveux central › Anticonvulsivants › Declining malformation rates with changed...
questionsmedicales.fr › Maladies du système nerveux › Maladies du système nerveux central › Encéphalopathies › Épilepsie › Declining malformation rates with changed...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Declining malformation rates with changed...
questionsmedicales.fr › Sciences sociales › Internationalité › Declining malformation rates with changed...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › Declining malformation rates with changed...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Prestations des soins de santé › Types de pratiques des médecins › Declining malformation rates with changed...
questionsmedicales.fr › Phénomènes physiologiques des appareils urinaire et reproducteur › Phénomènes physiologiques de la reproduction › Reproduction › Grossesse › Declining malformation rates with changed...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Collecte de données › Registre civil › Morbidité › Prévalence › Declining malformation rates with changed...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études prospectives › Declining malformation rates with changed...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Collecte de données › Enregistrements › Declining malformation rates with changed...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Jeune adulte › Declining malformation rates with changed...