PREDICTING RASH FROM LAMOTRIGINE: RESULTS FROM REVIEW OF 812 PATIENTS
Abstract number :
2.297
Submission category :
Year :
2003
Submission ID :
2151
Source :
www.aesnet.org
Presentation date :
12/6/2003 12:00:00 AM
Published date :
Dec 1, 2003, 06:00 AM
Authors :
Lawrence J. Hirsch, Jan Claassen, Hilary T. Spencer, Richard Buchsbaum, David J. Adams, Carl W. Bazil, Stanley R. Resor, Jr. Comprehensive Epilepsy Center, Dept. of Neurology, Columbia University, New York, NY; Biostatistics Dept., Mailman School of Publi
To determine risk factors for developing a rash from lamotrigine (LTG).
The Columbia AED Database is a retrospectively entered database of patients having been seen at the Columbia Comprehensive Epilepsy Center since the turn of the millennium. For this study, we included all patients having received LTG at any time. Charts were reviewed for documentation of [ldquo]allergy[rdquo] or [ldquo]rash[rdquo] developing to any medication, including antiepileptic drugs (AEDs) and non-AEDs, and including remote histories of rashes. Risk factors studied included gender, age, immune disorders, epilepsy syndrome and prior allergic reactions. Chi square analysis was used to determine statistical significance.
Overall, 35/812 (4%) patients developed a rash; there were no occurrences of Stevens-Johnson syndrome or toxic epidermal necrolysis. The only significant predictor of rash to LTG was prior rash to another medication. In patients with a prior rash to an AED, 21/90 (23%) developed a rash to LTG compared to 14/722 (2%) without a prior rash to an AED (p[lt]0.001). In patients with a prior rash to a non-AED, 6/66 (9%) developed a rash to LTG versus 29/746 (4%) without a prior rash to a non-AED (p=0.046). In patients with a prior rash to 2 or more AEDs, 8/24 (33%) developed a rash to LTG (p[lt]0.001). Age was not a risk factor: 3/58 (5%) patients under age 13 years had a rash compared with 32/754 (4%) over age 12. None of the 13 patients with an immune disorder developed a rash (N.S). There was a trend towards more rashes in females than males (6% vs. 3%, p=0.08).
The only significant predictor of rash from LTG was prior medication-induced rash, particularly from other AEDs. In patients with a prior AED-induced rash, 23% developed a rash on LTG, compared to only 2% of patients without a prior AED-induced rash.
[Supported by: The Columbia AED Database is funded by Glaxo, Pfizer, Ortho-McNeil and Elan.]