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*Only for medical professionals to read for reference.
Real-world research in Asian population: incidence of serious skin adverse reactions caused by anti-epileptic drugs.
Background and purpose of the study.
Patients receiving anti-epileptic drugs often have skin-related adverse reactions, including severe skin adverse reactions ( SCARs) are a rare adverse reaction that can lead to multiple organ failure, prolong hospitalization, and increase the risk of death, but few studies have reported the incidence of antiepileptic drugs SCARs.
Therefore, this study evaluated the incidence of SCARs in 7 commonly used antiepileptic drugs, including carbamazepine, phenytoin, oxcarbazepine, lamotrigine, zonisamide, levetiracetam, and topiramate.
Compare the risks associated with the drugs.
Research method This study collected 7 kinds of first prescriptions of carbamazepine, phenytoin, oxcarbazepine, lamotrigine, zonisamide, levetiracetam and topiramate in the Korean medical insurance database from January 2012 to December 2018 All patient data of antiepileptic drugs are used for correlation analysis of the incidence of SCARs.
Among them, SCARs are defined as the occurrence of any of Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), drug reaction with eosinophilia, and systemic symptoms (DRESS) in ICD-10 Kind.
Research results ■ Among all patients included in the incidence of SCARs with different antiepileptic drugs, 302,104, 50,908, 82,818, 86,632, 23,316, 312,971, 258,218 patients received carbamazepine, phenytoin, oxcarbazepine, lamotrigine, In the treatment of zonisamide, levetiracetam and topiramate, the incidence of topiramate SCARs was the lowest (400/1,000,000 person-years), and the incidence of phenytoin SCARs was the highest (5750/1,000,000 person-years) (see Table 1).
Table 1 The incidence of SCARs of different anti-epileptic drugs At the same time, in order to compare the difference in the incidence of SCARs of different anti-epileptic drugs, this study chose carbamazepine and levetiracetam as benchmarks for comparison with other anti-epileptic drugs.
The results show: ➤ The incidence of SCARs in patients treated with topiramate was significantly lower than that of carbamazepine (P<0.
05), and the incidence of SCARs in patients treated with phenytoin and lamotrigine was significantly higher than that of carbamazepine (both P<0.
05); ➤Accepted The incidence of SCARs in patients treated with topiramate was significantly lower than that of levetiracetam (P<0.
05), and the incidence of SCARs of other antiepileptic drugs except carbamazepine was significantly higher than that of levetiracetam (all P<0.
05).
■ SCARs-related risk factors for different anti-epileptic drugs ➤Gender: Male epilepsy patients using zonisamide are significantly associated with an increased risk of SCARs, but do not include antiepileptic drugs such as topiramate and levetiracetam.
➤Comorbid skin diseases: Comorbid skin diseases will significantly increase the incidence of SCARs related to the use of antiepileptic drugs such as carbamazepine, phenytoin, oxcarbazepine, lamotrigine, or levetiracetam, but does not increase the use of topiramate Risk of occurrence of SCARs.
➤Common liver disease: Comorbid liver disease will significantly increase the risk of SCARs using drugs such as carbamazepine or phenytoin, but will not increase the risk of using antiepileptic drugs such as topiramate and levetiracetam.
➤Comorbid allergic diseases: Comorbid allergic diseases will not significantly increase the risk of SCARs using topiramate and other 7 anti-epileptic drugs.
Discussion This study compared the incidence of seven antiepileptic drugs, SCARs, and is the largest database study in this field in Asia.
Compared with a large database study in the United Kingdom, the overall incidence of SCARs in this study is relatively high, which indicates that there are certain differences in the genetic susceptibility of antiepileptic drugs to the risk of SCARs in different countries.
It is worth mentioning that the UK database study did not observe that topiramate and levetiracetam cause SJS or TEN.
This study also shows that patients treated with topiramate have the relatively lowest risk of SCARs.
Topiramate is a new type of non-aromatic antiepileptic drug and has the relatively lowest risk of SCARs.
In addition, comorbid diseases and concomitant medications can also affect the risk of SCARs.
In addition to patients receiving topiramate treatment, patients with skin diseases are more likely to develop SCARs.
For patients with skin diseases, topiramate is a better medication choice.
Literature index: Chung SJ, Ahn K, Ji HO, et al.
Incidence rates of severe cutaneous adverse reactions due to antiseizure medication: A nationwide study using health claims data inKorea[J].
Epilepsia, 2020.
*Only used for medical and health care Professionals provide scientific information and do not represent the views of the platform
Real-world research in Asian population: incidence of serious skin adverse reactions caused by anti-epileptic drugs.
Background and purpose of the study.
Patients receiving anti-epileptic drugs often have skin-related adverse reactions, including severe skin adverse reactions ( SCARs) are a rare adverse reaction that can lead to multiple organ failure, prolong hospitalization, and increase the risk of death, but few studies have reported the incidence of antiepileptic drugs SCARs.
Therefore, this study evaluated the incidence of SCARs in 7 commonly used antiepileptic drugs, including carbamazepine, phenytoin, oxcarbazepine, lamotrigine, zonisamide, levetiracetam, and topiramate.
Compare the risks associated with the drugs.
Research method This study collected 7 kinds of first prescriptions of carbamazepine, phenytoin, oxcarbazepine, lamotrigine, zonisamide, levetiracetam and topiramate in the Korean medical insurance database from January 2012 to December 2018 All patient data of antiepileptic drugs are used for correlation analysis of the incidence of SCARs.
Among them, SCARs are defined as the occurrence of any of Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), drug reaction with eosinophilia, and systemic symptoms (DRESS) in ICD-10 Kind.
Research results ■ Among all patients included in the incidence of SCARs with different antiepileptic drugs, 302,104, 50,908, 82,818, 86,632, 23,316, 312,971, 258,218 patients received carbamazepine, phenytoin, oxcarbazepine, lamotrigine, In the treatment of zonisamide, levetiracetam and topiramate, the incidence of topiramate SCARs was the lowest (400/1,000,000 person-years), and the incidence of phenytoin SCARs was the highest (5750/1,000,000 person-years) (see Table 1).
Table 1 The incidence of SCARs of different anti-epileptic drugs At the same time, in order to compare the difference in the incidence of SCARs of different anti-epileptic drugs, this study chose carbamazepine and levetiracetam as benchmarks for comparison with other anti-epileptic drugs.
The results show: ➤ The incidence of SCARs in patients treated with topiramate was significantly lower than that of carbamazepine (P<0.
05), and the incidence of SCARs in patients treated with phenytoin and lamotrigine was significantly higher than that of carbamazepine (both P<0.
05); ➤Accepted The incidence of SCARs in patients treated with topiramate was significantly lower than that of levetiracetam (P<0.
05), and the incidence of SCARs of other antiepileptic drugs except carbamazepine was significantly higher than that of levetiracetam (all P<0.
05).
■ SCARs-related risk factors for different anti-epileptic drugs ➤Gender: Male epilepsy patients using zonisamide are significantly associated with an increased risk of SCARs, but do not include antiepileptic drugs such as topiramate and levetiracetam.
➤Comorbid skin diseases: Comorbid skin diseases will significantly increase the incidence of SCARs related to the use of antiepileptic drugs such as carbamazepine, phenytoin, oxcarbazepine, lamotrigine, or levetiracetam, but does not increase the use of topiramate Risk of occurrence of SCARs.
➤Common liver disease: Comorbid liver disease will significantly increase the risk of SCARs using drugs such as carbamazepine or phenytoin, but will not increase the risk of using antiepileptic drugs such as topiramate and levetiracetam.
➤Comorbid allergic diseases: Comorbid allergic diseases will not significantly increase the risk of SCARs using topiramate and other 7 anti-epileptic drugs.
Discussion This study compared the incidence of seven antiepileptic drugs, SCARs, and is the largest database study in this field in Asia.
Compared with a large database study in the United Kingdom, the overall incidence of SCARs in this study is relatively high, which indicates that there are certain differences in the genetic susceptibility of antiepileptic drugs to the risk of SCARs in different countries.
It is worth mentioning that the UK database study did not observe that topiramate and levetiracetam cause SJS or TEN.
This study also shows that patients treated with topiramate have the relatively lowest risk of SCARs.
Topiramate is a new type of non-aromatic antiepileptic drug and has the relatively lowest risk of SCARs.
In addition, comorbid diseases and concomitant medications can also affect the risk of SCARs.
In addition to patients receiving topiramate treatment, patients with skin diseases are more likely to develop SCARs.
For patients with skin diseases, topiramate is a better medication choice.
Literature index: Chung SJ, Ahn K, Ji HO, et al.
Incidence rates of severe cutaneous adverse reactions due to antiseizure medication: A nationwide study using health claims data inKorea[J].
Epilepsia, 2020.
*Only used for medical and health care Professionals provide scientific information and do not represent the views of the platform
