Evidence map›Paper›PMID 41099219›Full record

ArticlePharmacoepidemiology and drug safety2025

Secular Trends in the Use of Valproate-Containing Medicines in Women of Childbearing Age in Europe: A Multinational DARWIN EU Network Study.

Lucía Bellas, Martí Català, Edward Burn, Yuchen Guo, Mike Du, Katia Verhamme, Egil Fridgeirsson, Talita Duarte-Salles, Tommi Kauko, Eeva Kronqvist and 5 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Pharmacoepidemiology and drug safety, 2025. 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
–field-weighted citation impact
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.

  1. Article
  2. Article
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

15 authors.

Lucía BellasPharmacoepidemiology- and Device Group, NDORMS, University of Oxford, Oxford, UK.ORCID 0000-0001-8255-9841
Martí CatalàPharmacoepidemiology- and Device Group, NDORMS, University of Oxford, Oxford, UK.
Edward BurnPharmacoepidemiology- and Device Group, NDORMS, University of Oxford, Oxford, UK.
Yuchen GuoPharmacoepidemiology- and Device Group, NDORMS, University of Oxford, Oxford, UK.
Mike DuPharmacoepidemiology- and Device Group, NDORMS, University of Oxford, Oxford, UK.
Katia VerhammeDepartment of Medical Informatics, Erasmus Medical Center, Rotterdam, the Netherlands.
Egil FridgeirssonDepartment of Medical Informatics, Erasmus Medical Center, Rotterdam, the Netherlands.
Talita Duarte-SallesDepartment of Medical Informatics, Erasmus Medical Center, Rotterdam, the Netherlands.
Tommi KaukoAuria Clinical Informatics, ACI VARHA, Turku University Hospital, Turku, Finland.
Eeva KronqvistAuria Clinical Informatics, ACI VARHA, Turku University Hospital, Turku, Finland.
James T BrashIQVIA, Real World Solutions, Brighton, UK.
Sarah SeagerIQVIA, Real World Solutions, Brighton, UK.
Daniel Prieto-AlhambraPharmacoepidemiology- and Device Group, NDORMS, University of Oxford, Oxford, UK.
Annika M JödickePharmacoepidemiology- and Device Group, NDORMS, University of Oxford, Oxford, UK.
Albert Prats-UribePharmacoepidemiology- and Device Group, NDORMS, University of Oxford, Oxford, UK.

Funding

DARWIN EU
6 · The paper itself

Abstract

backgroundValproate-containing medicines (VPA) are first-line treatments for epilepsy; however, they pose teratogenic risks, restricting their use in women of childbearing age. We aimed to estimate the secular trends in the use of VPA and alternative treatments in young women, and to characterise dose/strength, treatment duration, and indication in new VPA users.

methodsWe conducted a multi-national population-based cohort study using primary care records from the Netherlands, Spain, and the UK (IPCI, SIDIAP, CPRD GOLD), primary and outpatient specialist care records from Germany and Belgium (IQVIA DA Germany, IQVIA LPD Belgium), and hospital records from Finland (ACI VARHA), all mapped to the OMOP Common data model. All women present in the databases aged ≥ 12 and ≤ 55 years on the 1st of January of each year in the period 2010-2022 (or latest available), with at least 365 days of prior observation, were included.

resultsA total of 2 948 860 (CPRD GOLD), 718 835 (IPCI), 2 494 052 (SIDIAP), 157 361 (ACI VARHA), 218 250 (IQVIA LPD Belgium); and 5 152 752 (IQVIA DA Germany) women were included. Among those, 6416, 1241, 10 398, 1447, 945, and 4002 started treatments with VPA, respectively. Incidence and prevalence of VPA use in young women decreased between 2010 and 2021, while the prevalence of the alternative treatments pregabalin and gabapentin increased, especially in CPRD (it rises from 0.5% to 1.5%). Median age of new VPA users ranged between 40 and 43 years. Anxiety and depressive disorder were frequent comorbidities, and the use of hormonal contraceptives we were able to capture was low. Average treatment duration varied substantially across databases.

conclusionIncidences and prevalence of use of VPA among young women declined since 2015. Conversely, alternative antiepileptics have increased in uptake, particularly gabapentinoids. The use of standardized federated analytics allowed for a rapid assessment of VPA utilization, supporting the regulatory agencies in their decision-making and improving patient safety across Europe.

Indexed as

AnticonvulsantsEpilepsyValproic AcidAdolescentAdultChildCohort StudiesDatabases, FactualEuropeFemaleHumansMiddle AgedYoung AdultAnticonvulsantsValproic Acidantiepileptic drugsdrug utilizationnetwork studypharmacoepidemiology

Identifiers

PMID41099219
PMCPMC12529455

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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.