Department of Pharmacy, Tohoku Medical and Pharmaceutical University Hospital, 1-12-1 Fukumuro, Miyagino-ku, Sendai, Miyagi 983-8512, Japan.
Department of Molecular Epidemiology, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Division of Preventive Medicine and Epidemiology, Tohoku University Tohoku Medical Megabank Organization, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Department of Pharmaceutical Sciences, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan.
Seizure. 2022 May;98:101-104. doi: 10.1016/j.seizure.2022.04.007. Epub 2022 Apr 14.
The temporal trends in prescribing anti-seizure medicines (ASMs) for pregnant women with epilepsy are unclear. In this study, we investigated the trends in ASM prescriptions in pregnant Japanese women with epilepsy.
Administrative data (as of December 2021), pertaining to Japanese pregnant outpatient women with epilepsy, aged 16-49 years, who visited hospitals between January 1, 2016 and December 31, 2020 were included in the study. Annual prescription trends in ASMs during this period were calculated based on the proportions. The Cochran-Armitage trend test was used to evaluate the proportion of prescriptions for each ASM.
The numbers of pregnant women with epilepsy were 404, 421, 368, 378, 386 for the years 2016, 2017, 2018, 2019, and 2020, respectively. As of 2020, levetiracetam had the highest proportion of prescriptions, followed by lamotrigine and valproic acid. From 2016 to 2020, the proportions of levetiracetam and lamotrigine prescribed for pregnant women with epilepsy have increased significantly from 19.1% to 30.8% and from 12.1% to 18.4%, respectively. In contrast, there was no temporal change in the proportion of valproic acid prescribed, which was 12.4% in 2016 and 10.1% in 2020.
Our findings suggest that the trends in the prescription of ASMs in Japanese pregnant women outpatients with epilepsy have shifted toward ASMs with a lower teratogenic risk.
抗癫痫药物（ASMs）在癫痫孕妇中的用药趋势尚不清楚。本研究旨在调查日本癫痫孕妇 ASM 处方的变化趋势。
本研究纳入了 2016 年 1 月 1 日至 2020 年 12 月 31 日期间在医院就诊的年龄在 16-49 岁的日本癫痫门诊孕妇的行政数据（截至 2021 年 12 月）。根据比例计算了该期间 ASM 的年度处方趋势。采用 Cochran-Armitage 趋势检验评估每种 ASM 的处方比例。
2016 年、2017 年、2018 年、2019 年和 2020 年的癫痫孕妇人数分别为 404、421、368、378 和 386 人。截至 2020 年，左乙拉西坦的处方比例最高，其次是拉莫三嗪和丙戊酸。从 2016 年到 2020 年，左乙拉西坦和拉莫三嗪在癫痫孕妇中的处方比例从 19.1%显著增加到 30.8%和从 12.1%增加到 18.4%，而丙戊酸的处方比例没有时间变化，分别为 12.4%和 10.1%。
我们的研究结果表明，日本癫痫门诊孕妇 ASM 处方的趋势已向致畸风险较低的 ASM 转移。
