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

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Title: Topiramate ban in women of childbearing potential with idiopathic generalized epilepsy: Does effectiveness offset the teratogenic risks?
Authors: Cerulli Irelli, Emanuele (AUTHOR), Cocchi, Enrico (AUTHOR), Mostacci, Barbara (AUTHOR), Orlando, Biagio (AUTHOR), Gesche, Joanna (AUTHOR), Caraballo, Roberto H. (AUTHOR), Lattanzi, Simona (AUTHOR), Strigaro, Gionata (AUTHOR), Catania, Cecilia (AUTHOR), Pulitano, Patrizia (AUTHOR), Panzini, Chiara (AUTHOR), Ferlazzo, Edoardo (AUTHOR), Pascarella, Angelo (AUTHOR), Casciato, Sara (AUTHOR), Pizzanelli, Chiara (AUTHOR), Giuliano, Loretta (AUTHOR), Viola, Veronica (AUTHOR), Fortunato, Francesco (AUTHOR), Di Gennaro, Giancarlo (AUTHOR), Gambardella, Antonio (AUTHOR)
Source: Epilepsia (Series 4). Mar2024, Vol. 65 Issue 3, pe27-e34. 8p.
Subjects: Termination of treatment, Epilepsy, Topiramate, Treatment failure, Government agencies
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. [ABSTRACT FROM AUTHOR]
Copyright of Epilepsia (Series 4) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Topiramate ban in women of childbearing potential with idiopathic generalized epilepsy: Does effectiveness offset the teratogenic risks?
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  Data: <searchLink fieldCode="JN" term="%22Epilepsia+%28Series+4%29%22">Epilepsia (Series 4)</searchLink>. Mar2024, Vol. 65 Issue 3, pe27-e34. 8p.
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  Data: <searchLink fieldCode="DE" term="%22Termination+of+treatment%22">Termination of treatment</searchLink><br /><searchLink fieldCode="DE" term="%22Epilepsy%22">Epilepsy</searchLink><br /><searchLink fieldCode="DE" term="%22Topiramate%22">Topiramate</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+failure%22">Treatment failure</searchLink><br /><searchLink fieldCode="DE" term="%22Government+agencies%22">Government agencies</searchLink>
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  Data: 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. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Epilepsia (Series 4) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=176105005
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        Value: 10.1111/epi.17892
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      – Code: eng
        Text: English
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      – SubjectFull: Topiramate
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