Department of Pharmacoeconomics and Social Pharmacy, Karol Marcinkowski University of Medical Sciences, Rokietnicka 7, 60-806 Poznan, Poland.
Department of Developmental Neurology, Karol Marcinkowski University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznan, Poland.
Int J Environ Res Public Health. 2022 Apr 8;19(8):4509. doi: 10.3390/ijerph19084509.
To investigate the occurrence of adverse effects of antiepileptic drugs (AEDs) in pediatric epileptic patients on mono- or polytherapy.
We evaluated eighty consecutive patients that met the following inclusion criteria: aged ≤18 years; diagnosed with epilepsy for at least one year; a stable dose of AED for at least three months; verbal consent to participation in the study. Patients were asked if they had experienced any adverse drug reaction (ADR) related to the AED. Afterward, regardless of the answer, they were interviewed based on a detailed semi-structured questionnaire about the presence of ADRs associated with the AED. The data were analyzed regarding the use of monotherapy or polytherapy.
Ninety-seven percent of the patients reported having experienced ADRs related to AEDs. The greatest number of seizures affected the group of patients treated with monotherapy (both at baseline and at followup), but the greatest number of ADRs were observed among patients treated with polytherapy. In patients on monotherapy, the most frequent ADRs reported at baseline included fatigue and somnolence, and among patients with polytherapy, it was fatigue and hair loss.
Children on polytherapy were significantly more likely to develop ADRs compared to those on monotherapy, but a statistically significant improvement in seizure frequency was also observed in the group of patients on polytherapy. Pharmacovigilance is very important in children with AEDs, so that ADRs can be identified early and managed appropriately.
调查单药或多药治疗的儿科癫痫患者抗癫痫药物(AED)不良反应的发生情况。
我们评估了 80 例符合以下纳入标准的连续患者:年龄≤18 岁;至少诊断为癫痫一年;AED 剂量稳定至少三个月;口头同意参与研究。询问患者是否经历过与 AED 相关的任何药物不良反应(ADR)。之后,无论答案如何,根据详细的半结构化问卷对与 AED 相关的 ADR 进行访谈。对单药或多药治疗的数据进行分析。
97%的患者报告称经历过与 AED 相关的 ADR。在基线和随访时,接受单药治疗的患者癫痫发作次数最多,但接受多药治疗的患者 ADR 最多。在接受单药治疗的患者中,报告的最常见的 ADR 包括疲劳和嗜睡,而在接受多药治疗的患者中,疲劳和脱发是最常见的 ADR。
与单药治疗相比,多药治疗的儿童更有可能发生 ADR,但多药治疗组的癫痫发作频率也有统计学意义的改善。药物警戒在儿童 AED 中非常重要,以便及早识别 ADR 并进行适当的管理。