Evidence map›Paper›PMID 29411348›Full record

ArticleEpilepsia2018

Risk of pharmacokinetic interactions between antiepileptic and other drugs in older persons and factors associated with risk.

Edward Faught, Jerzy P Szaflarski, Joshua Richman, Ellen Funkhouser, Roy C Martin, Kendra Piper, Chen Dai, Lucia Juarez, Maria Pisu

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Epilepsia, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 2 pooled it
4.7field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 27 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Edward FaughtDepartment of Neurology, Emory University, Atlanta, GA, USA.
Jerzy P SzaflarskiDepartment of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA.
Joshua RichmanDepartment of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
Ellen FunkhouserDivision of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Roy C MartinDepartment of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA.
Kendra PiperDepartment of Gynecology and Obstetrics, Emory University, Atlanta, GA, USA.
Chen DaiDivision of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Lucia JuarezDivision of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Maria PisuDivision of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
University of Alabama at Birmingham · USEmory University · US

Funding

Quality of Epilepsy Treatment and Costs in Older Americans by Race (QUIET CARE)R01NS080898 · NINDS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI PISU, MARIA · 2012 to 2014
$1.1M
NINDS NIH HHS R01 NS080898
6 · The paper itself

Abstract

objectiveTo determine the frequency of older Americans with epilepsy receiving concomitant prescriptions for antiepileptic drugs (AEDs) and non-epilepsy drugs (NEDs) which could result in significant pharmacokinetic (PK) interaction, and to assess the contributions of racial/ethnic, socioeconomic, and demographic factors.

methodsRetrospective analyses of 2008-2010 Medicare claims for a 5% random sample of beneficiaries ≥67 years old in 2009 augmented for minority representation. Prevalent cases had ≥1 ICD-9 345.x or ≥2 ICD-9 780.3x, and ≥1 AED. Among them, incident cases had no seizure/epilepsy claim codes nor AEDs in preceding 365 days. Drug claims for AEDs, and for the 50 most common NEDs within +/- 60 days of the index epilepsy date were tabulated. Interacting pairs of AEDs/NEDs were identified by literature review. Logistic regression models were used to examine factors affecting the likelihood of interaction risk.

resultsInteracting drug pairs affecting NED efficacy were found in 24.5% of incident, 39% of prevalent cases. Combinations affecting AED efficacy were found in 20.4% of incident, 29.3% of prevalent cases. Factors predicting higher interaction risk included having ≥ 1 comorbidity, being eligible for Part D low Income Subsidy, and not living in the northeastern US. Protective factors were Asian race/ethnicity, and treatment by a neurologist. SIGNIFICANCE: A substantial portion of older epilepsy patients received NED-AED combinations that could cause important PK interactions. The lower frequency among incident vs. prevalent cases may reflect changes in prescribing practices. Avoidance of interacting AEDs is feasible for most persons because of the availability of newer drugs.

Indexed as

AgedAged, 80 and overAnticonvulsantsDrug InteractionsDrug Therapy, CombinationFemaleHumansInsurance Claim ReportingMaleMedicareRetrospective StudiesRisk FactorsUnited StatesAnticonvulsantsantiepileptic drugsepilepsyethnicityinteractionsraceseizures

Identifiers

PMID29411348
PMCPMC5844842
OpenAlexW2790292583

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.