Sistema de Salut de Catalunya
[Giner-Soriano M] Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain. Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Bellaterra, Spain. [Marsal J] Unitat d’Epidemiologia, Servei de Cardiologia, Hospital Universitari Vall d’Hebron, Barcelona, Spain. [Gomez-Lumbreras A] Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain. Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Bellaterra, Spain. Facultat de Medicina, Universitat de Girona, Girona, Spain. [Morros R] Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain. Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Bellaterra, Spain. Institut Català de la Salut, Barcelona, Spain
IDIAP Jordi Gol
2021-05-26T12:55:23Z
2021-05-26T12:55:23Z
2021-05-24
Antiepileptic drugs; Stroke; Electronic health records
Medicaments antiepilèptics; Embòlia; Registres electrònics de salut
Medicamentos antiepilépticos; Embolia; Registros electrónicos de salud
Background Cerebrovascular disorders have occurred more frequently in some Central Nervous System (CNS) disorders, such as epilepsy. Some CNS drugs have been associated with increased stroke risk. Our aim was to estimate the risk of ischaemic stroke in patients exposed to antiepileptic drugs (AED). Methods Population-based matched case-control study using SIDIAP database, based in electronic health records from primary healthcare from Catalonia, Spain. Cases were those patients with a registered diagnosis of first stroke during 2009–2014. Up to 10 controls were selected for each case and matched by sex, age, and geographic area and without a prior diagnosis of stroke. We considered global drug exposure to AED, past and current exposure and exposure in monotherapy to each AED. Results 2,865 cases and 19,406 controls were exposed to AED during the study period. Global exposure to levetiracetam [(ORadj3.3, CI95 % 2.8-4.0)], phenytoin [ORadj1.5, CI95 % 1.2–41.9)], and valproic acid [(ORadj 1.3, CI95 % 1.1–1.6)], showed significantly association to ischaemic stroke that was also maintained with current exposure of levetiracetam [ORadj4.1, CI95 % 3.3–5.2)] and valproic acid [ORadj1.4, CI95 % 1.1–1.9)]. Current levetiracetam monotherapy showed a very high risk of ischaemic stroke [(ORadj 5.1, CI95 % 3.7–6.9)]. Conclusions Drugs used for other conditions than epilepsy (pregabalin, gabapentin) were the most used AED and both did not show a risk. Levetiracetam shows a risk for stroke even when assessed in current monotherapy. The lack of data regarding the link with diagnosis and severity in our study makes it necessary to conduct further studies to confirm or dismiss our results, focussing on levetiracetam.
This study has been funded by Bioibérica S.A.
Article
Published version
English
Anticonvulsius - Efectes secundaris - Catalunya; Embòlia; CHEMICALS AND DRUGS::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Central Nervous System Agents::Anticonvulsants; Other subheadings::Other subheadings::Other subheadings::/adverse effects; DISEASES::Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Cerebrovascular Disorders::Stroke; Catalonia; COMPUESTOS QUÍMICOS Y DROGAS::acciones y usos químicos::acciones farmacológicas::usos terapéuticos::fármacos del sistema nervioso central::anticonvulsivantes; Otros calificadores::Otros calificadores::Otros calificadores::/efectos adversos; ENFERMEDADES::enfermedades del sistema nervioso::enfermedades del sistema nervioso central::enfermedades cerebrales::trastornos cerebrovasculares::accidente cerebrovascular; Cataluña
BMC
BMC Neurology;21
https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-021-02237-1
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
Articles científics - HVH [3437]
