Evidence map›Paper›PMID 37931389›Full record

ArticleEpilepsy & behavior : E&B2023

Lamotrigine and exogenous estrogen among females with epilepsy: A retrospective analysis of administrative claims data.

Laura Kirkpatrick, Samuel W Terman, Elizabeth Harrison, Page B Pennell

Open access · greenAbstract read
In one paragraph

Article in Epilepsy & behavior : E&B, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
3.5field-weighted citation impact, top 7% 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

1 citing paper in PubMed, 6 citations in OpenAlex.

  1. 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

4 authors at 2 institutions in 1 country.

Laura KirkpatrickUniversity of Pittsburgh, Department of Neurology, USA; University of Pittsburgh, Department of Pediatrics, USA. Electronic address: laua.kirpatrick2@chp.edu.
Samuel W TermanUniversity of Michigan, Department of Neurology, USA. Electronic address: sterman@umich.edu.
Elizabeth HarrisonUniversity of Pittsburgh, Department of Pediatrics, USA. Electronic address: harrisonei2@upmc.edu.
Page B PennellUniversity of Pittsburgh, Department of Neurology, USA. Electronic address: pennellpb@upmc.edu.
University of Pittsburgh · USUniversity of Michigan · US

Funding

Child Neurologist Career Development Program (CNCDP)K12NS098482 · NINDS · HUGO W. MOSER RES INST KENNEDY KRIEGER · PI SCHLAGGAR, BRADLEY L · 2016 to 2025
$26.2M
NICHD NIH HHS L40 HD113008NINDS NIH HHS K12 NS098482
6 · The paper itself

Abstract

objectiveExogenous estrogen reduces lamotrigine serum concentrations. Little is known about whether providers adjust lamotrigine doses for addition of exogenous estrogen among people with epilepsy, despite expert recommendations. We determined the incidence of dose increases in lamotrigine following incident prescription of estrogen among females with epilepsy (FWE) in claims data.

methodsWe used Optum's de-identified Clinformatics® Data Mart Database to create a cohort of U.S. FWE prescribed lamotrigine at a stable dose, with a subsequent prescription for estrogen from 2011 to 2021. We calculated cumulative incidence functions of dose increases in lamotrigine following prescription of exogenous estrogen. We performed a Cox proportional hazards model for multiple candidate predictors of a lamotrigine dose increase.

resultsThe cohort included 643 FWE, with median age of 31 (interquartile ratio [IQR] 20-42). The cumulative incidence of any lamotrigine increase was 28% (95% confidence interval [CI] 25%-32%). The median number of days after the first estrogen fill until the first lamotrigine adjustment was 118 (IQR 48-188). In unadjusted Cox models, older age, use of estrogen in hormone replacement therapy as opposed to contraception, and annual household income of $50,000-$99,999 (compared with <$50,000) were significant negative predictors of a dose adjustment in lamotrigine with hazard ratios (HRs) of 0.82 (95% CI 0.72-0.92), 0.63 (95% CI 0.42-0.95), and 0.62 (95% CI 0.40-0.95). In the adjusted Cox model, age and income remained significant predictors with HRs of 0.79 (95% CI 0.66-0.94) and 0.59 (95% CI 0.36-0.95).

conclusionDose increase of lamotrigine following addition of exogenous estrogen is rare among U.S. FWE, with potential disparities based on age and income level. More guidance may be needed for providers on this topic.

Indexed as

AnticonvulsantsEpilepsyEstrogensFemaleHumansLamotrigineRetrospective StudiesAnticonvulsantsEstrogensLamotrigineClaims dataDrug interactionsEstrogenLamotrigineWomen with epilepsy

Identifiers

PMID37931389
PMCPMC12949926
OpenAlexW4388330666

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.