The Relative Effects of Sociodemographics, Comorbidities, and Epilepsy Features on Antiseizure Medication Side Effects
Abstract number :
2.285
Submission category :
7. Anti-seizure Medications / 7D. Drug Side Effects
Year :
2023
Submission ID :
831
Source :
www.aesnet.org
Presentation date :
12/3/2023 12:00:00 AM
Published date :
Authors :
Presenting Author: Corinne McCabe, MD – Nationwide Children's Hospital
Mariah Eisner, Ms – Ohio State University; Stephanie Ahrens, DO – Nationwide Children's Hospital; Christopher Beatty, MD – Nationwide Children's Hospital; Jamie Twanow, MD – Nationwide Children's Hospital; Adam Ostendorf, MD – Nationwide Children's Hospital
Rationale:
Seizures can be controlled using one anti-seizure medication (ASM) in approximately 50% of people with epilepsy. ASM tolerability, not just efficacy, is essential in medication compliance, seizure treatment, and overall quality of life1,2. The Pediatric Epilepsy Side Effect Questionnaire (PESQ) is a patient or proxy-reported, 19-item measure with five subscales in cognitive, motor, behavioral, general neurological, and weight domains validated to measure ASM side effects in children3. In children with epilepsy who are seizure-free on ASM monotherapy, we hypothesized: 1) PESQ scores increase with increasing doses; 2) median PESQ scores would differ between ASMs; 3) median PESQ scores would be higher in those with ADHD or mood disorders.
Methods:
We included 781 children seizure-free on ASM monotherapy from a single center taking the most commonly prescribed ASMs. Variables analyzed alongside PESQ scores included age, sex, race, insurance coverage, social history score, school accommodations/developmental delay, anxiety/depression diagnosis, ADHD diagnosis, epilepsy duration, and ASM. Age distributions by medication/indication were compared with box plots and the Kruskal-Wallis rank sum test. Medications and indications were compared by sex, race, and insurance payer with the chi-squared test. Pearson correlation coefficients were computed for each ASM between daily dosages and total PESQ scores. Multivariable modeling was conducted utilizing zero-inflated Poisson regression.
Results:
ASMs included levetiracetam (n=397), oxcarbazepine (n=130), zonisamide (n=79), lamotrigine (n=74), ethosuximide (n=65), and valproic acid/divalproex (n=36). Total PESQ scores were not associated with higher doses of medications (Figure 1). The odds ratio (OR) for reporting a positive PESQ total score was only significant for those with abnormal development or school modifications (OR 4.55, 95% CI 2.69-7.69, p< 0.001)
Anti-seizure Medications