Sex Differences in Adverse Effects of Antiseizure Medications in Adults with Epilepsy: A Systematic Review.

Journal

CNS drugs

ISSN: 1179-1934

Titre abrégé: CNS Drugs

Pays: New Zealand

ID NLM: 9431220

Informations de publication

Date de publication:
30 Apr 2024

Historique:

accepted: 19 03 2024

medline: 1 5 2024

pubmed: 1 5 2024

entrez: 1 5 2024

Statut: aheadofprint

Résumé

Sex differences in epilepsy have been described in prevalence, seizure propensity and response to treatment. Therefore, taking into account sex-based differences in epilepsy is important for both diagnostic purposes and therapeutic considerations. However, little is known about sex differences in adverse effects of antiseizure medications (ASMs). We performed a systematic review searching for sex differences in adverse effects of ASMs in adult persons with epilepsy (PWE) as part of a wider project aimed to assess sex-based differences in efficacy and adverse effects of ASMs in PWE. We conducted a comprehensive literature search in the PubMed database. The search was conducted with no restriction on publication date, and all results up to April 2020 were included. We included articles written in English, Italian, Spanish, or French that evaluated adverse effects of one or more ASMs in PWE, with specific mention of the two sexes. When appropriate, Newcastle-Ottawa or Jadad scales were used to assess study quality. Of 5164 identified studies, only 167 considered sex in the analysis and were therefore included. Significant sex-related differences were found in 58 of those studies. We found a consistently higher frequency of cutaneous adverse effects in females; higher risk of developing general adverse effects on different ASMs in females; stronger risk of adverse effects on bone metabolism in females, mainly on treatment with enzyme-inducing ASMs; a concordant higher risk of visual field loss was noted in males on vigabatrin; an overall worse lipid profile in males; as well as higher leptin levels and higher body mass index in females treated with various ASMs. Our analysis has identified some important sex differences in the adverse effects of ASMs. Clinicians should be aware of these differences when informing patients about the risks associated with ASM treatment in PWE.

Sections du résumé

BACKGROUND BACKGROUND

OBJECTIVES OBJECTIVE

We performed a systematic review searching for sex differences in adverse effects of ASMs in adult persons with epilepsy (PWE) as part of a wider project aimed to assess sex-based differences in efficacy and adverse effects of ASMs in PWE.

METHODS METHODS

We conducted a comprehensive literature search in the PubMed database. The search was conducted with no restriction on publication date, and all results up to April 2020 were included. We included articles written in English, Italian, Spanish, or French that evaluated adverse effects of one or more ASMs in PWE, with specific mention of the two sexes. When appropriate, Newcastle-Ottawa or Jadad scales were used to assess study quality.

RESULTS RESULTS

Of 5164 identified studies, only 167 considered sex in the analysis and were therefore included. Significant sex-related differences were found in 58 of those studies. We found a consistently higher frequency of cutaneous adverse effects in females; higher risk of developing general adverse effects on different ASMs in females; stronger risk of adverse effects on bone metabolism in females, mainly on treatment with enzyme-inducing ASMs; a concordant higher risk of visual field loss was noted in males on vigabatrin; an overall worse lipid profile in males; as well as higher leptin levels and higher body mass index in females treated with various ASMs.

CONCLUSIONS CONCLUSIONS

Our analysis has identified some important sex differences in the adverse effects of ASMs. Clinicians should be aware of these differences when informing patients about the risks associated with ASM treatment in PWE.

Identifiants

DOI: 10.1007/s40263-024-01088-x PMID: 38691320

pubmed: 38691320

doi: 10.1007/s40263-024-01088-x

pii: 10.1007/s40263-024-01088-x

doi:

Types de publication

Systematic Review

Langues

eng

Sous-ensembles de citation

Informations de copyright

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Sex Differences in Adverse Effects of Antiseizure Medications in Adults with Epilepsy: A Systematic Review.

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Loretta Giuliano (L)

Vania Durante (V)

Giulia Battaglia (G)

Sara Gasparini (S)

Elena Zambrelli (E)

Caterina Ermio (C)

Angela La Neve (A)

Barbara Mostacci (B)

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