Practice Trends in Women with Epilepsy
Abstract number :
2.161
Submission category :
4. Clinical Epilepsy / 4E. Women's Issues
Year :
2022
Submission ID :
2204452
Source :
www.aesnet.org
Presentation date :
12/4/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:25 AM
Authors :
Praveen Kumar Ramani, MD – University of Arkansas for Medical Sciences; Sisira Yadala, MD – University of Arkansas for Medical Sciences; Abhilash Thatikala, MD – University of Arkansas for Medical Sciences; Krishna Nalleballe, MD – University of Arkansas for Medical Sciences.
Rationale: To study the practice trends of clinicians treating women with epilepsy (WWE). This study focuses on prevalence of use of valproic acid in WWE in child bearing age group and use of folic acid to minimize potential teratogenicity and improve fetal neuro-cognitive outcomes.
Methods: De-identified data was extracted using TriNetX, which is a Global health collaborative clinical research platform collecting real time electronic medical records data from healthcare organizations. The data collected in this study are between January 1, 2015, and January 26, 2022, from 57 organizations in the U.S. and other countries. Of these data, 93% is from the U.S., 1% is from outside the U.S., and 7% is from unknown regions.
Results: Number of women with epilepsy (WWE) with ICD-10 code G40 (Epilepsy and recurrent seizures) in age group 15-45 years was 157,334 with mean age of 31±9. Of these patients, 17,355 (11%) were prescribed valproate (mean age, 31±9). Among all WWE in age range 15-45, 36,602 (23%) were on folic acid (mean age, 32±7). Of the 17,355 patients on valproate, only 5255 (30%) were on folic acid supplementation (mean age, 32±8). Among WWE in age group 15-45 yrs, 97,849 patients were on at least one the following anti-seizure medications: zonisamide, carbamazepine, locasamide, oxcarbazepine, topiramate, phenytoin, vigabatrin, levetiracetam, phenobarbital, eslicarbazepine, perampanel, valproate. Amongst these, 27,965 (28.5%) were on folic acid (mean age, 32±7).
Conclusions: Based on available data, several organizations including the AAN (American Academy of Neurology) and the AES (American Epilepsy Society) recommend avoidance of valproate use in women of child bearing age group due to substantial risk of major congenital malformations and adverse neuro-cognitive outcomes and recommend use of folic acid supplementation. However, our study finds that there is a practice gap between recommendations and clinician practice trends illustrating the need for more clinician education and need for involvement of epileptologists in the care of these patients to ensure best outcomes.
Funding: Not applicable
Clinical Epilepsy