| Title: |
Second-Line Medications for Women Aged 10 to 50 Years With Idiopathic Generalized Epilepsy |
| Authors: |
Cerulli Irelli, Emanuele; Cocchi, Enrico; Gesche, Joanna; Peña-Ceballos, Javier; Caraballo, Roberto H; Lattanzi, Simona; Strigaro, Gionata; Morano, Alessandra; Moloney, Patrick B; Ferlazzo, Edoardo; Pascarella, Angelo; Mazzeo, Adolfo; D'Aniello, Alfredo; Pizzanelli, Chiara; Milano, Chiara; Giuliano, Loretta; Viola, Veronica; Mostacci, Barbara; Fortunato, Francesco; Pulitano, Patrizia; Burani, Margherita; Meletti, Stefano; Pignatta, Pietro; Perulli, Marco; Battaglia, Domenica; Rosati, Eleonora; Delanty, Norman; Di Gennaro, Giancarlo; Gambardella, Antonio; Labate, Angelo; Operto, Francesca F; Giallonardo, Anna T; Beier, Christoph P; Di Bonaventura, Carlo; BISULLI, FRANCESCA |
| Contributors: |
Cerulli Irelli, Emanuele; Cocchi, Enrico; Gesche, Joanna; Peña-Ceballos, Javier; Caraballo, Roberto H; Lattanzi, Simona; Strigaro, Gionata; Morano, Alessandra; Moloney, Patrick B; Ferlazzo, Edoardo; Pascarella, Angelo; Mazzeo, Adolfo; D'Aniello, Alfredo; Pizzanelli, Chiara; Milano, Chiara; Giuliano, Loretta; Viola, Veronica; Mostacci, Barbara; Fortunato, Francesco; Pulitano, Patrizia; Burani, Margherita; Meletti, Stefano; Pignatta, Pietro; Perulli, Marco; Battaglia, Domenica; Rosati, Eleonora; Delanty, Norman; Di Gennaro, Giancarlo; Gambardella, Antonio; Labate, Angelo; Operto, Francesca F; Giallonardo, Anna T; Beier, Christoph P; Di Bonaventura, Carlo; Bisulli, Francesca |
| Publication Year: |
2025 |
| Collection: |
IRIS Università degli Studi di Bologna (CRIS - Current Research Information System) |
| Subject Terms: |
epilepsy; Idiopathic Generalized Epilepsy; seizure; antiseizure medications; pediatric epilepsy; women |
| Description: |
Importance: Women with idiopathic generalized epilepsy (IGE) face challenges in treatment due to limited options that are both effective and safe. Objective: To evaluate the effectiveness and safety of substitution monotherapy vs add-on therapy as second-line options for women who might become pregnant with IGE after failure of first-line antiseizure medications (ASMs) other than valproic acid. Design, setting, and participants: Multicenter retrospective comparative effectiveness cohort study at 18 primary, secondary, and tertiary adult and children epilepsy centers across 4 countries, analyzing data from 1995 to 2023. Participants were women aged 10 to 50 years diagnosed with IGE who were prescribed a second line of ASM. Main outcomes and measures: Treatment failure (TF), defined as the replacement or addition of a second ASM due to ineffectiveness, was compared between patients receiving ASM add-on or substitution monotherapy using inverse probability of treatment weighting (IPTW)-adjusted Cox proportional hazards regression. Exploratory analyses were also conducted to assess the effectiveness of individual ASMs and various ASM combinations. Results: This study included 249 women with a median (IQR) age of 18.0 (15.5-22.0) years. Among them, 146 (58.6%) received an add-on regimen, and 103 (41.4%) received substitution monotherapy. During follow-up, TF occurred in 48 patients (32.9%) receiving add-on therapy and 36 (35.0%) using substitution monotherapy, with no significant differences between groups (IPTW-adjusted hazard ratio [HR], 0.89; 95% CI, 0.53-1.51; P = .69). ASM discontinuation due to ineffectiveness or adverse effects occurred in 36 patients (24.7%) receiving add-on therapy and 29 (28.2%) receiving substitution monotherapy, showing no significant differences (IPTW-adjusted HR, 0.97; 95% CI, 0.57-1.65; P = .92). Rates of ASM discontinuation due to adverse effects only were low in both groups, occurring in 13 patients (9.0%) receiving add-on therapy and 9 (8.7%) receiving a substitution monotherapy. ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
ELETTRONICO |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/40063025; info:eu-repo/semantics/altIdentifier/wos/WOS:001445034700004; volume:8; issue:3; firstpage:1; lastpage:12; numberofpages:12; journal:JAMA NETWORK OPEN; https://hdl.handle.net/11585/1007259; https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2831184 |
| DOI: |
10.1001/jamanetworkopen.2025.0354 |
| Availability: |
https://hdl.handle.net/11585/1007259; https://doi.org/10.1001/jamanetworkopen.2025.0354; https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2831184 |
| Rights: |
info:eu-repo/semantics/openAccess |
| Accession Number: |
edsbas.17899CCC |
| Database: |
BASE |