Women of childbearing age: What antiseizure medications are they taking?
Women of childbearing age: What antiseizure medications are they taking?
复制标题
育龄妇女：她们正在服用哪些抗癫痫药物？
DOI：
10.1111/bcp.15555
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发表时间：
2023
影响因子：
3.4
通讯作者：
Birnbaum,AngelaK
中科院分区：
文献类型：
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作者：
Avachat,Charul;Birnbaum,AngelaK
对于癫痫等慢性疾病，癫痫的管理通常涉及终生用药。选择给育龄患者开的抗癫痫药物(ASM)是很重要的，因为患者并不总是知道他们将在什么时候怀孕，因此，胎儿接触可能是不可避免的。ASM也用于癫痫以外的情况，因此，由于对非癫痫情况的处理可能不同，因此使用的分布可能会根据适应症而有所不同。为患者确定理想的ASM目标剂量通常涉及确定平衡癫痫控制和不良事件的浓度，从而在最大限度地减少胎儿接触药物的同时最大化疗效。艾尔是为了检查意大利伦巴第地区育龄妇女和孕妇的ASM处方趋势1。从2010年1月1日至2019年12月31日收集了四个地方卫生单位的数据，其中包括三个数据库，其中包含门诊药物处方信息、住院出院和出生证明。药物处方和医院出院数据库中的患者数据使用与每个患者相关的唯一字母数字代码进行匹配。确定ASM使用总体流行率的纳入标准是在研究期间至少开出一种ASM处方，其中ASM根据解剖治疗化学物质(ATC)分类系统的N03A亚组定义。育龄妇女被定义为15-49岁的妇女，年龄范围反映了作者数据集中生育的妇女的年龄。同一年龄段的男性被包括在内，以提供一个比较对照组。为了了解ASM处方在不同人群中的流行情况，与联合数据库进行了几次比较。在2019年的育龄妇女中，大约15%的人在整个研究期间至少接受了一种ASM，其使用率类似。最常见的ASM是普瑞巴林、丙戊酸盐、托吡酯和左乙拉西坦，在接受至少一种ASM处方的患者中，范围从22.3%到13.1%不等。与2010年相比，到2019年丙戊酸盐的处方减少了约10%。丙戊酸盐使用量的这种下降趋势是
For a chronic disease such as epilepsy, management of seizures often involves lifelong medication use. The choice of antiseizure medication (ASM) prescribed to patients of childbearing age is important as patients are not always aware of when they will become pregnant, therefore, fetal exposure may not be avoidable. ASMs are also used for conditions other than epilepsy, thus the distribution of use may vary according to indication as management of non-epilepsy conditions may not be similar. Determining the ideal ASM target doses for a patient often involves identification of the concentration that balances seizure control and adverse events, thus maximizing efficacy whilst minimizing fetal exposure to drug.The primary aim of the study by Clavenna A, et. al. was to examine the prescribing trends of ASMs in women of childbearing age and pregnant women in the Lombardy region of Italy1. Data from four local health units were collected between January 1, 2010, to December 31, 2019 which included three databases containing outpatient drug prescription information, hospital discharge and birth certificates. Patient data from drug prescription and hospital discharge databases were matched using unique alphanumeric codes associated with every patient. The inclusion criterion for determination of the overall prevalence of ASM use was at least one prescription of an ASM during the study period with an ASM defined according to the N03A subgroup of the Anatomical Therapeutic Chemical (ATC) Classification System. Women of childbearing age were defined as those women of ages 15–49 years, the age range mirroring the ages of women who gave birth in the author’s dataset. Men belonging to the same age group were included to provide a comparison control group. Several comparisons were made with the combined databases to understand prevalence of ASM prescriptions in different groups. In women of childbearing age in 2019, approximately 15% received at least one ASM with a similar prevalence of use over the whole study period. The most frequent ASMs identified were pregabalin, valproate, topiramate, and levetiracetam ranging from 22.3% to 13.1% of patients identified as receiving at least one ASM prescription. In comparison to 2010, the prescription of valproate decreased by approximately 10% by 2019. This decreased trend in valproate use has been