Abstract Details

Title Discontinuation Rates for Hormonal Contraception on Enzyme Inducing versus Other Antiepileptic Drug Categories: Interim Analysis of the Epilepsy Birth Control Registry

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P2 - Poster Session 2 (5:30 PM-6:30 PM)

Poster/Presentation
Number 6-001

Objective To report Epilepsy Birth Control Registry prospective findings regarding discontinuation rates for systemic hormonal (HC) versus non-hormonal contraception (NHC) in relation to enzyme inducing (EI) and other antiepileptic drug (AED) categories taken by women with epilepsy (WWE) in the community.

Background Retrospective EBCR survey data find that the rates of discontinuation and unintended pregnancy on HC are greater on EIAEDs than other AEDs. Prospective data reports are lacking.

Design/Methods

This prospective web-based EBCR serial survey study compared the frequencies of discontinuation for adverse reasons of newly started HC (oral contraceptive pills, vaginal ring, patch, depomedroxyprogesterone, implanted progestins) versus NHC (withdrawal, barrier, intrauterine device) on EI and other (glucuronidated, non enzyme-inducing, enzyme-inhibiting) categories of AEDs within 3-12 months of follow-up of WWE in the community between 2016-18 (N = 153). Comparisons are reported as risk ratios (RRs) with 95% confidence intervals (95% CIs).

Results Overall rate of discontinuation of any contraceptive method by one year was 64/153, 41.8%. Discontinuation of HC was greater than NHC 45/82, 54.9% v 19/71, 26.8%: RR = 2.05 (1.33 to 3.16), p = 0.0011. Using NHC on other AEDs as reference (11/42, 26.2%), NHC on EIAED discontinuation (8/29, 27.6%) RR was 1.05 (0.48-2.29), p = NS. HC on other AEDs (35/69, 50.7%) RR was 1.94 (1.11-3.39), p = 0.0203, and HC on EIAED (10/13, 76.9%) RR was 2.94 (1,63-5.29), p = 0.0003. Relative to HC on other AEDs, RR for HC on EIAED was 1.52 (1.04-2.21), p = 0.0308. Relative to NHC on EIAED, RR for HC on EIAED was 2.79 (1.44-5.40), p = 0.0023.

Conclusions These EBCR prospective study findings suggest that the combination of HC with EIAED has a high likelihood of discontinuation within a year (76.9%), greater than the combination of other AEDs with HC (50.7%) and any AED category with NHC (26.8%).

Authors/Disclosures
Andrew G. Herzog, MD, MSc, FAAN PRESENTER	Dr. Herzog has nothing to disclose.
	No disclosure on file
	No disclosure on file

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