Evidence map›Paper›PMID 34775242›Full record

ArticleEpilepsy & behavior : E&B2021

Antiseizure medications and oral contraceptives: Impact of enzyme inducers on pregnancy outcomes and costs.

Seri Anderson, Josephine Mauskopf, Sandra E Talbird, Annesha White, Meenakshi Srinivasan

Open access · hybridAbstract read
In one paragraph

Article in Epilepsy & behavior : E&B, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.7field-weighted citation impact, top 15% 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

2 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Review
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

5 authors at 2 institutions in 1 country.

Seri AndersonRTI Health Solutions, 3040 Cornwallis Road, Research Triangle Park, NC 27709, USA. Electronic address: saanderson@rti.org.
Josephine MauskopfRTI Health Solutions, 3040 Cornwallis Road, Research Triangle Park, NC 27709, USA. Electronic address: jmauskopf@rti.org.
Sandra E TalbirdRTI Health Solutions, 3040 Cornwallis Road, Research Triangle Park, NC 27709, USA. Electronic address: stalbird@rti.org.
Annesha WhiteUniversity of North Texas System College of Pharmacy, 3500 Camp Bowie Blvd, IREB Office 211, Fort Worth, TX 76107, USA. Electronic address: Annesha.white@unthsc.edu.
Meenakshi SrinivasanUniversity of North Texas System College of Pharmacy, 3500 Camp Bowie Blvd, IREB Office 211, Fort Worth, TX 76107, USA. Electronic address: msrinivasan@cop.ufl.edu.
RTI Health Solutions · USUniversity of North Texas · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo show the impact of drug-drug interactions (DDIs) associated with co-administration of enzyme-inducing (EI) antiseizure medications and oral contraceptives (OCs) on the annual number of unintended pregnancies, their outcomes, and their associated costs in the United States (US).

methodsA Microsoft Excel pregnancy-outcomes model was developed to determine the impact of DDIs in women who take an OC as well as an EI antiseizure medication known to lower the effectiveness of the OC in preventing pregnancy. The model compared the number of unintended pregnancies, the expected pregnancy outcomes, and associated costs in women taking an OC and an EI medication with a matched cohort of women who took an OC and an enzyme-neutral (EN) antiseizure medication that is known not to interact with OCs. The model perspectives were patients and third-party payers in the US. Unintended pregnancy rates, pregnancy outcomes, and cost inputs for the model were taken from published studies.

resultsThe results of the analysis showed an estimated increase in the annual number of unintended pregnancies in the US of 503 (a change from 1151 to 1654), an increase of 44.7%, for the estimated 71,922 women currently taking an OC plus an EI medication in the US when compared with a matched cohort taking an OC plus an EN medication. This resulted in an estimated annual healthcare cost increase of $3 million, which is an increase of 5.5% in the annual costs for contraception and pregnancy care. A scenario analysis showed that the annual number of unintended pregnancies could be lower (575 vs 1654) for a matched cohort of women taking EI medications and using a copper intrauterine device, a highly effective and nonhormonal form of contraception, rather than an OC.

conclusionsPhysicians treating women of reproductive age for epilepsy who wish to avoid pregnancy should consider the potential for DDIs that might result in unintended pregnancies. Thus, physicians should alert women using EI medications for epilepsy control to the increased potential for unintended pregnancies if they use OCs for contraception.

Indexed as

Contraceptives, OralPharmaceutical PreparationsContraceptionDrug InteractionsFemaleHumansPregnancyPregnancy OutcomeUnited StatesContraceptives, OralPharmaceutical PreparationsAntiseizure medicationsCostsDrug–drug interactionsOral contraceptivesUnintended pregnancy

Identifiers

PMID34775242
PMCPMC8683747
OpenAlexW3212767641

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.