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

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Title: Sex Differences in Adverse Effects of Antiseizure Medications in Adults with Epilepsy: A Systematic Review.
Authors: Giuliano, Loretta (AUTHOR), Durante, Vania (AUTHOR), Battaglia, Giulia (AUTHOR), Gasparini, Sara (AUTHOR), Zambrelli, Elena (AUTHOR), Ermio, Caterina (AUTHOR), La Neve, Angela (AUTHOR), Mostacci, Barbara (AUTHOR)
Source: CNS Drugs. Jun2024, Vol. 38 Issue 6, p409-423. 15p.
Subjects: Anticonvulsants, Gender, Adults, Epilepsy, People with epilepsy, Body mass index, Visual fields
Abstract: Background: 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). Objectives: 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: 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: 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: 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. [ABSTRACT FROM AUTHOR]
Copyright of CNS Drugs is the property of Springer Nature 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: Sex Differences in Adverse Effects of Antiseizure Medications in Adults with Epilepsy: A Systematic Review.
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  Data: <searchLink fieldCode="AR" term="%22Giuliano%2C+Loretta%22">Giuliano, Loretta</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Durante%2C+Vania%22">Durante, Vania</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Battaglia%2C+Giulia%22">Battaglia, Giulia</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Gasparini%2C+Sara%22">Gasparini, Sara</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Zambrelli%2C+Elena%22">Zambrelli, Elena</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Ermio%2C+Caterina%22">Ermio, Caterina</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22La+Neve%2C+Angela%22">La Neve, Angela</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Mostacci%2C+Barbara%22">Mostacci, Barbara</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22CNS+Drugs%22">CNS Drugs</searchLink>. Jun2024, Vol. 38 Issue 6, p409-423. 15p.
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  Data: <searchLink fieldCode="DE" term="%22Anticonvulsants%22">Anticonvulsants</searchLink><br /><searchLink fieldCode="DE" term="%22Gender%22">Gender</searchLink><br /><searchLink fieldCode="DE" term="%22Adults%22">Adults</searchLink><br /><searchLink fieldCode="DE" term="%22Epilepsy%22">Epilepsy</searchLink><br /><searchLink fieldCode="DE" term="%22People+with+epilepsy%22">People with epilepsy</searchLink><br /><searchLink fieldCode="DE" term="%22Body+mass+index%22">Body mass index</searchLink><br /><searchLink fieldCode="DE" term="%22Visual+fields%22">Visual fields</searchLink>
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  Data: Background: 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). Objectives: 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: 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: 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: 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. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of CNS Drugs is the property of Springer Nature 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.)
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              Text: Jun2024
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