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30-04-2024 | Carbamazepine | Systematic Review

Sex Differences in Adverse Effects of Antiseizure Medications in Adults with Epilepsy: A Systematic Review

Authors: Loretta Giuliano, Vania Durante, Giulia Battaglia, Sara Gasparini, Elena Zambrelli, Caterina Ermio, Angela La Neve, Barbara Mostacci, the Epilepsy, Gender Commission of the LICE (Italian chapter of the ILAE)

Published in: CNS Drugs | Issue 6/2024

Abstract

Background

Sex differences in epilepsy have been described in prevalence, seizure propensity and response to treatment. Therefore, taking into account sex-based differences in epilepsy is important for both diagnostic purposes and therapeutic considerations. However, little is known about sex differences in adverse effects of antiseizure medications (ASMs).

Objectives

We performed a systematic review searching for sex differences in adverse effects of ASMs in adult persons with epilepsy (PWE) as part of a wider project aimed to assess sex-based differences in efficacy and adverse effects of ASMs in PWE.

Methods

We conducted a comprehensive literature search in the PubMed database. The search was conducted with no restriction on publication date, and all results up to April 2020 were included. We included articles written in English, Italian, Spanish, or French that evaluated adverse effects of one or more ASMs in PWE, with specific mention of the two sexes. When appropriate, Newcastle-Ottawa or Jadad scales were used to assess study quality.

Results

Of 5164 identified studies, only 167 considered sex in the analysis and were therefore included. Significant sex-related differences were found in 58 of those studies. We found a consistently higher frequency of cutaneous adverse effects in females; higher risk of developing general adverse effects on different ASMs in females; stronger risk of adverse effects on bone metabolism in females, mainly on treatment with enzyme-inducing ASMs; a concordant higher risk of visual field loss was noted in males on vigabatrin; an overall worse lipid profile in males; as well as higher leptin levels and higher body mass index in females treated with various ASMs.

Conclusions

Our analysis has identified some important sex differences in the adverse effects of ASMs. Clinicians should be aware of these differences when informing patients about the risks associated with ASM treatment in PWE.

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Title: Sex Differences in Adverse Effects of Antiseizure Medications in Adults with Epilepsy: A Systematic Review
Authors: Loretta Giuliano
Vania Durante
Giulia Battaglia
Sara Gasparini
Elena Zambrelli
Caterina Ermio
Angela La Neve
Barbara Mostacci
the Epilepsy, Gender Commission of the LICE (Italian chapter of the ILAE)
Publication date: 30-04-2024
Publisher: Springer International Publishing
Keywords: Carbamazepine
Epilepsy
Phenytoin
Lamotrigine
Oxcarbazepine
Levetiracetam
Published in: CNS Drugs / Issue 6/2024
Print ISSN: 1172-7047
Electronic ISSN: 1179-1934
DOI: https://doi.org/10.1007/s40263-024-01088-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Sex Differences in Adverse Effects of Antiseizure Medications in Adults with Epilepsy: A Systematic Review

Abstract

Background

Objectives

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Objectives

Methods

Results

Conclusions

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