Abstract Details

Title Malformation Risk Of Newer AEDs In Women With Epilepsy

Topic Epilepsy/Clinical Neurophysiology (EEG)

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

Poster/Presentation
Number 6-007

Objective To explore the malformation risk of newer AEDs – lamotrigine (LTG), levetiracetam (LEV), and clobazam (CLB) as against other AEDs.

Background The risk of major congenital malformation (MCM) associated with antenatal AED exposure to valproate and other older AEDs have led to search for alternate pharmacotherapy for epilepsy in women of reproductive age group.

Design/Methods

This registry is enrolling WWE in preconception stage or first trimester of pregnancy (before the malformation status of the fetus is known) and prospectively following up the pregnancy until delivery and the infants through adolescence. The use of an AED anytime during the first trimester was treated as exposure. Malformation screening consisted of detailed anomaly scan before 18 weeks of pregnancy, physical examination at birth, echocardiography and abdomen ultrasound examination at 3 months of age and review at one year of age.

Results The registry had 146 fetus/infants with MCM (6.7%) in the 2190 completed pregnancies with known final outcome. The AED exposure as mono or polytherapy and the MCM rate for the AEDs were lamotrigine 86, 1.2%, clonazepam 56, 5.4%, oxcarbazepine 116, 6%, carbamazepine 792, 6.6%, levetiracetam 135, 6.7%, clobazam 263, 7.6%, valproate 447, 9.4% and topiramate 33, 24.2%. The MCM rate for monotherapy (n=1332, MCM= 77 MCM rate= 5.8%) was significantly lower (p=.015) than that of polytherapy (n=685, MCM=58, MCM rate 8.5%). The exposures and MCM rates for the AED monotherapies were lamotrigine 45, 2.2%, levetiracetam 88, 5%, clonazepam 3,0%, clobazam 10, 20%, valproate 323, 7.1% and topiramate 10, 0%.) The relative risk (95% confidence interval) for MCM (with reference to LTG monotherapy) for the other AEDs were levetiracetam 2.56 (0.31-21.23), valproate 3.2 (0.44-23.15).

Conclusions

The MCM rates as monotherapy and polytherapy were lowest for lamotrigine. Intermediate for oxcarbazepine and levetiracetam and high for valproate and clobazam..

Authors/Disclosures
Sanjeev V. Thomas, MD, FAAN (Institute for Communicative and Cognitive Neurosciences) PRESENTER	Dr. Thomas has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Wiley India. The institution of Dr. Thomas has received research support from Government of India.
	No disclosure on file
	No disclosure on file
	No disclosure on file

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