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Incidence rates of severe cutaneous adverse reactions due to antiseizure medication: A nationwide study using health claims data in Korea.
- Source :
-
Epilepsia [Epilepsia] 2021 Jan; Vol. 62 (1), pp. 250-257. Date of Electronic Publication: 2020 Nov 13. - Publication Year :
- 2021
-
Abstract
- Objective: Antiseizure medications (ASMs) can rarely result in severe, sometimes fatal, cutaneous adverse reactions. To date, few studies have reported on the incidence rates (IRs) of severe cutaneous adverse reactions (SCARs) due to ASM use. This study aimed to determine the IRs of SCAR resulting from the use of seven commonly prescribed ASMs, carbamazepine (CBZ), phenytoin (PHT), oxcarbazepine (OXC), lamotrigine (LMT), zonisamide (ZNS), levetiracetam (LVT), and topiramate (TPM), and to compare the associated risks among the drugs.<br />Methods: Using a nationwide health claims database, we selected all the patients prescribed with one of the target ASMs. We defined a SCAR case as the first hospitalization with one of three specific codes provided by the International Classification of Diseases, 10th revision (L511, L512, and L27). We then calculated the IR of SCARs according to each target ASM.<br />Results: The IR of SCARs for each ASM was as follows: 870/1 000 000 person-years (PYs) for CBZ, 5750/1 000 000 PYs for PHT, 1490/1 000 000 PYs for OXC, 3860/1 000 000 PYs for LMT, 1540/1 000 000 PYs for ZNS, 830/1 000 000 PYs for LVT, and 400/1 000 000 PYs for TPM. Concomitant use of antibiotics and nonsteroidal anti-inflammatory drugs significantly increased the risk of SCARs with OXC, LVT, or TPM use. Comorbid skin disease was associated with a significantly higher IR of SCARs from CBZ, PHT, OXC, LMT, or LVT use.<br />Significance: This is the first study in Asia to determine the IRs of SCARs for various ASMs and compare the rates across drugs using a large dataset. The results from this study should help clinicians select safer ASMs in practice.<br /> (© 2020 International League Against Epilepsy.)
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Carbamazepine adverse effects
Child
Drug Hypersensitivity Syndrome etiology
Female
Humans
Incidence
Lamotrigine adverse effects
Levetiracetam adverse effects
Male
Middle Aged
Oxcarbazepine adverse effects
Phenytoin adverse effects
Republic of Korea epidemiology
Severity of Illness Index
Stevens-Johnson Syndrome etiology
Topiramate adverse effects
Young Adult
Zonisamide adverse effects
Anticonvulsants adverse effects
Drug Hypersensitivity Syndrome epidemiology
Stevens-Johnson Syndrome epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1528-1167
- Volume :
- 62
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Epilepsia
- Publication Type :
- Academic Journal
- Accession number :
- 33188522
- Full Text :
- https://doi.org/10.1111/epi.16751