Epilepsy & behavior : E&B · 2026
Risk of cutaneous adverse reactions to lamotrigine and levetiracetam by age, sex, and reproductive status.
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Abe Takafumi, Neshige Shuichiro, Ohno Narumi, Ishihara Keito, Okada Riho, Yamazaki Yu, Iida Koji, Maruyama Hirofumi
Аннотация
PURPOSE: To assess the risk of cutaneous adverse drug reactions (CADRs) to lamotrigine (LTG) and levetiracetam (LEV) in relation to age, sex, and reproductive status.
METHODS: We examined 3,379 patients (mean age: 38.2 ± 23.9 years; 49.3% women) who initiated LTG (n = 1,040) or LEV (n = 2,339) between 2008 and 2024. The frequency and severity of CADRs induced by each drug were evaluated. Patients were categorized by age pediatric (0-14 years), young and middle-aged adults (15-64 years), and older adults (≥65 years). We performed univariate and multivariate analyses to identify factors associated with CADR occurrence, including reproductive status. We also assessed age-related trends in CADR frequency and examined the presence of CADRs in relation to childbirth events.
RESULTS: The frequency of LTG-induced CADRs was 3.2% (n = 33), including six severe cases (0.58%). Female sex was independently associated with LTG-induced CADRs (odds ratio = 2.44, p = 0.022). Among young and middle-aged adults, LTG-induced CADRs were more frequent in women than in men (5.0% vs. 1.4%,p = 0.013). The frequency exhibited an age-related increasing trend across the premenopausal period (p = 0.019) and declined sharply after menopause. Conversely, LEV-induced CADRs were rare (0.086%), mild, and not significantly associated with age or sex. Among 63 childbirth events, no CADRs occurred during the pregnancy period.
CONCLUSIONS: LTG-induced CADRs occurred more frequently in women of reproductive age, whereas LEV demonstrated a favorable safety profile. These findings suggest that age- and sex-related clinical factors, including pregnancy-related information, may be associated with the frequency of LTG-induced CADRs; however, the role of hormonal factors, including hormonal contraception, requires further prospective investigation.
METHODS: We examined 3,379 patients (mean age: 38.2 ± 23.9 years; 49.3% women) who initiated LTG (n = 1,040) or LEV (n = 2,339) between 2008 and 2024. The frequency and severity of CADRs induced by each drug were evaluated. Patients were categorized by age pediatric (0-14 years), young and middle-aged adults (15-64 years), and older adults (≥65 years). We performed univariate and multivariate analyses to identify factors associated with CADR occurrence, including reproductive status. We also assessed age-related trends in CADR frequency and examined the presence of CADRs in relation to childbirth events.
RESULTS: The frequency of LTG-induced CADRs was 3.2% (n = 33), including six severe cases (0.58%). Female sex was independently associated with LTG-induced CADRs (odds ratio = 2.44, p = 0.022). Among young and middle-aged adults, LTG-induced CADRs were more frequent in women than in men (5.0% vs. 1.4%,p = 0.013). The frequency exhibited an age-related increasing trend across the premenopausal period (p = 0.019) and declined sharply after menopause. Conversely, LEV-induced CADRs were rare (0.086%), mild, and not significantly associated with age or sex. Among 63 childbirth events, no CADRs occurred during the pregnancy period.
CONCLUSIONS: LTG-induced CADRs occurred more frequently in women of reproductive age, whereas LEV demonstrated a favorable safety profile. These findings suggest that age- and sex-related clinical factors, including pregnancy-related information, may be associated with the frequency of LTG-induced CADRs; however, the role of hormonal factors, including hormonal contraception, requires further prospective investigation.