Choi Junyeong, Yoon Dongwon, Park Minhee, Joung Kyung-In, Shin Ju-Young
School of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi-do, South Korea.
Medicine (Baltimore). 2020 Oct 16;99(42):e22669. doi: 10.1097/MD.0000000000022669.
Despite safety concerns associated with topiramate use, the pattern of adverse events and signal analysis of antiepileptic drugs remain elusive.We aimed to determine patient demographics and characteristics of reported AEs of topiramate and to detect the associated signals by comparing those of other antiepileptics.We used the Korea Institute of Drug Safety & Risk Management-Korea Adverse Event Reporting System Database (KIDS-KD) from 2010 to 2017 to determine patient demographics and characteristics of reported AEs for topiramate and other antiepileptics. The proportional reporting ratio, reporting odds ratio, and information component were used in signal detection. Signals were compared against drug labels in Korea, the UK, the EU, and the US.A total of 1300 adverse events cases of topiramate were reported, and the number of topiramate-adverse event pairs was 1861. For topiramate, the proportion of women of childbearing age (20-39 years) with adverse events was more than double that for other antiepileptics. A majority of the 36 detected signals were of neuropsychiatric disorders such as cognitive disorders, concentration impaired, amnesia, hypoaesthesia. Patients with topiramate-induced adverse events were likely to be young and female. Also, adverse events related to carbonic anhydrase isoenzyme showed specifically great disproportionalities.Rigorous clinical management is needed to ensure proper and safe use of topiramate. Special precautions should be taken when prescribing in women of childbearing age.
尽管托吡酯的使用存在安全问题,但抗癫痫药物的不良事件模式和信号分析仍然难以捉摸。我们旨在确定托吡酯报告的不良事件的患者人口统计学特征和特点,并通过与其他抗癫痫药物的特征进行比较来检测相关信号。我们使用了韩国药物安全与风险管理研究所-韩国不良事件报告系统数据库(KIDS-KD)2010年至2017年的数据,以确定托吡酯和其他抗癫痫药物报告的不良事件的患者人口统计学特征和特点。在信号检测中使用了比例报告率、报告比值比和信息成分。将信号与韩国、英国、欧盟和美国的药品标签进行了比较。共报告了1300例托吡酯不良事件病例,托吡酯-不良事件对的数量为1861。对于托吡酯,育龄期(20-39岁)出现不良事件的女性比例是其他抗癫痫药物的两倍多。检测到的36个信号中,大多数是神经精神障碍,如认知障碍、注意力受损、失忆、感觉减退。托吡酯引起不良事件的患者可能是年轻女性。此外,与碳酸酐酶同工酶相关的不良事件显示出特别大的不成比例性。需要严格的临床管理以确保托吡酯的正确和安全使用。在为育龄期女性开处方时应采取特殊预防措施。