Abstract Details

Title Comparative Efficacy of Valproate and Levetiracetam Monotherapy in Women of Childbearing Age with Juvenile Myoclonic Epilepsy: A Retrospective Cohort from Latin America

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P4 - Poster Session 4 (8:00 AM-9:00 AM)

Poster/Presentation
Number 10-002

Objective To compare seizure freedom between valproate (VPA) and levetiracetam (LEV) monotherapy in women of childbearing age with Juvenile Myoclonic Epilepsy (JME).

Background In the SANAD II study VPA was found to be the most effective antiseizure medication (ASMs) for JME. However, its teratogenic potential limits its use in women of childbearing age. Identifying alternative ASMs with comparable efficacy is crucial to balance seizure control and reproductive safety. LEV has emerged as a promising option.

Design/Methods A retrospective observational study of 60 females aged 15 to 49 years (the recognized reproductive-age range per WHO) who were on monotherapy with either valproate (n=25) or levetiracetam (n=35) from a single tertiary epilepsy center was conducted. Groups were comparable in age and epilepsy duration. Primary outcome: Seizure freedom ≥12 months for any seizure type and for generalized Tonic Clonic Seizure (GTCS). Statistical comparisons were performed using Chi-square and binary logistic regression adjusting for age at diagnosis and duration of treatment.

Results Seizure freedom was achieved in VPA 17/25 (68%) vs LEV 19/35 (54.3%), Freedom from GTCS was VPA 19/25 (76%) vs LEV 25/35 (71.4%). In the logistic regression model oriented as VPA vs LEV, the odds ratios (OR) for overall seizure and GTCS freedom were OR 1.79 (95% CI: 0.61–5.26) and OR 1.27 (95% CI: 0.39–4.17), respectively; after adjustment, the OR was 1.01 (95% CI: 0.27–3.70; p=0.98)

Conclusions We found no statistically significant differences between LEV and VPA in achieving seizure freedom. Point estimates and their 95% CIs were consistent with similar efficacy within the available precision. Given the teratogenic profile of VPA and reproductive safety considerations, LEV emerges as a reasonable alternative when minimizing fetal risk is prioritized; however, larger samples or non-inferiority studies are required to confirm comparability.

Authors/Disclosures
Juan C. Vera, Jr., Medical Student PRESENTER	Dr. Vera has nothing to disclose.
Stefan Narvaez-Labuhn, Medical Student	Mr. Narvaez-Labuhn has nothing to disclose.
Maximiliano D. Salgado Deza	Maximiliano D. Salgado Deza has nothing to disclose.
Fernando Vasquez Lopez, MD	Dr. Vasquez Lopez has nothing to disclose.
Irving Fuentes	Mr. Fuentes has nothing to disclose.
Betsy C. Vazquez, MD	Dr. Vazquez has nothing to disclose.
Jimena Gonzalez Salido, MD	Miss Gonzalez Salido has nothing to disclose.
Jimena Colado, MD	Dr. Colado has nothing to disclose.
Katherin M. Plasencia Correa, MD	Dr. Plasencia Correa has nothing to disclose.
Mariana Peschard Franco (Medica Sur)	Mrs. Peschard Franco has nothing to disclose.
Andres Felipe Morcillo Muñoz, Sr., MD	Dr. Morcillo Muñoz has nothing to disclose.
Alberto D. Cervantes, Sr., MD	Dr. Cervantes has nothing to disclose.
Mario Sebastian-Diaz, MD, PhD	Dr. Sebastian-Diaz has nothing to disclose.
Iris E. Martinez-Juarez, MD (Instituto Nacional de Neurología y Neurocirugía)	No disclosure on file

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