Predictors of Seizure Recurrence in Women With Idiopathic Generalized Epilepsy Who Switch From Valproate to Another Medication
Emanuele Cerulli Irelli, Enrico Cocchi, Alessandra Morano, Joanna Gesche, Roberto Caraballo, Simona Lattanzi, Gionata Strigaro, Eleonora Rosati, Cecilia Catania, Edoardo Ferlazzo, Sara Casciato, Giancarlo Di Gennaro, Chiara Pizzanelli, Loretta Giuliano, Veronica Viola, Barbara Mostacci, Pietro Pignatta, Francesco Fortunato, Patrizia Pulitano, Chiara Panzini, Antonio Gambardella, Arife Çimen Atalar, Angelo Labate, Francesca Felicia Operto, Anna Teresa Giallonardo, Betül Baykan, Christoph P. Beier, Carlo Di Bonaventura
Abstract
BACKGROUND AND OBJECTIVES: To investigate the predictors of seizure recurrence in women of childbearing age with idiopathic generalized epilepsy (IGE) who switched from valproate (VPA) to alternative antiseizure medications (ASMs) and compare the effectiveness of levetiracetam (LEV) and lamotrigine (LTG) as VPA alternatives after switch. METHODS: This multicenter retrospective study included women of childbearing age diagnosed with IGE from 16 epilepsy centers. Study outcomes included worsening or recurrence of generalized tonic-clonic seizure (GTCS) at 12 months and 24 months after the switch from VPA to an alternative ASM. The comparative effectiveness of LEV and LTG as alternative ASM following VPA discontinuation was assessed through inverse probability treatment-weighted (IPTW) Cox regression analysis. RESULTS: = 0.008) during the 24-month follow-up. DISCUSSION: Our findings can have practical implications for optimizing counselling and treatment choices in women of childbearing age with IGE and may help clinicians in making informed treatment decisions in this special population of patients. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that for women with IGE switching from VPA, LEV was associated with a reduced risk of GTCS worsening or recurrence compared with LTG.