Anti-epileptic drug use and subsequent degenerative dementia occurrence

IF 4.9 Q1 CLINICAL NEUROLOGY

Alzheimer''s and Dementia: Translational Research and Clinical Interventions Pub Date : 2024-09-10 DOI:10.1002/trc2.70001

Naoki Ikegaya, Honoka Nakamura, Yutaro Takayama, Yohei Miyake, Takahiro Hayashi, Masaki Sonoda, Mitsuru Sato, Kensuke Tateishi, Jun Suenaga, Masao Takaishi, Yu Kitazawa, Misako Kunii, Hiroki Abe, Tomoyuki Miyazaki, Tetsuaki Arai, Manabu Iwasaki, Takayuki Abe, Tetsuya Yamamoto

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引用次数: 0

Abstract

INTRODUCTION

The use of anti-epileptic drugs (AEDs) in degenerative dementia (DD) remains uncertain. We aimed to evaluate the association of early AED administration with subsequent DD occurrence.

METHODS

Using a large nationwide database, we enrolled patients newly diagnosed with epilepsy from 2014 to 2019 (n = 104,225), and using propensity score matching, we divided them into treatment (those prescribed AEDs in 2014) and control groups. The primary outcome was subsequent DD occurrence in 2019.

RESULTS

Overall, 4489 pairs of patients (2156 women) were matched. The odds ratio (treatment/control) for DD occurrence was 0.533 (95% confidence interval: 0.459–0.617). The DD proportions significantly differed between the treatment (340/4489 = 0.076) and control (577/4489 = 0.129) groups.

DISCUSSION

Among patients newly diagnosed with epilepsy, compared to non-use, early AED use was associated with a lower occurrence of subsequent DD. Further investigations into and optimization of early intervention for epilepsy in DD are warranted.

Highlights

Anti-epileptic drug (AED) use before epilepsy diagnosis was linked with a lower subsequent degenerative dementia (DD) occurrence.
Identifying the epileptic phenotype was crucial for justifying early AED use in DD.
AED use with an epilepsy diagnosis did not pose an additional risk of DD.
The potential contribution of combination drug therapy to the strategy was noted.

Abstract Image

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抗癫痫药物的使用与随后发生的退行性痴呆症

简介：抗癫痫药物（AEDs）在变性性痴呆（DD）中的应用仍不确定。我们旨在评估早期使用 AED 与随后发生 DD 的关系。方法我们利用一个大型全国性数据库，纳入了 2014 年至 2019 年新确诊的癫痫患者（n = 104,225 人），并采用倾向评分匹配法将其分为治疗组（2014 年开具 AED 的患者）和对照组。主要结果是 2019 年随后的 DD 发生率。结果共有 4489 对患者（2156 名女性）进行了匹配。发生 DD 的几率比（治疗组/对照组）为 0.533（95% 置信区间：0.459-0.617）。治疗组（340/4489 = 0.076）和对照组（577/4489 = 0.129）的 DD 比例有明显差异。讨论在新确诊的癫痫患者中，与不使用 AED 的患者相比，早期使用 AED 与较低的后续 DD 发生率相关。有必要进一步调查和优化对 DD 患者的癫痫早期干预。亮点在癫痫确诊前使用抗癫痫药物（AED）与较低的退行性痴呆（DD）发生率有关。确定癫痫表型对于证明 DD 早期使用 AED 的合理性至关重要。在确诊为癫痫的情况下使用AED并不会增加患变性痴呆症的风险。研究人员注意到了联合用药治疗对这一策略的潜在贡献。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Alzheimer''s and Dementia: Translational Research and Clinical Interventions Medicine-Psychiatry and Mental Health

CiteScore

10.10

自引率

2.10%

发文量

134

审稿时长

10 weeks

期刊介绍： Alzheimer''s & Dementia: Translational Research & Clinical Interventions (TRCI) is a peer-reviewed, open access,journal from the Alzheimer''s Association®. The journal seeks to bridge the full scope of explorations between basic research on drug discovery and clinical studies, validating putative therapies for aging-related chronic brain conditions that affect cognition, motor functions, and other behavioral or clinical symptoms associated with all forms dementia and Alzheimer''s disease. The journal will publish findings from diverse domains of research and disciplines to accelerate the conversion of abstract facts into practical knowledge: specifically, to translate what is learned at the bench into bedside applications. The journal seeks to publish articles that go beyond a singular emphasis on either basic drug discovery research or clinical research. Rather, an important theme of articles will be the linkages between and among the various discrete steps in the complex continuum of therapy development. For rapid communication among a multidisciplinary research audience involving the range of therapeutic interventions, TRCI will consider only original contributions that include feature length research articles, systematic reviews, meta-analyses, brief reports, narrative reviews, commentaries, letters, perspectives, and research news that would advance wide range of interventions to ameliorate symptoms or alter the progression of chronic neurocognitive disorders such as dementia and Alzheimer''s disease. The journal will publish on topics related to medicine, geriatrics, neuroscience, neurophysiology, neurology, psychiatry, clinical psychology, bioinformatics, pharmaco-genetics, regulatory issues, health economics, pharmacoeconomics, and public health policy as these apply to preclinical and clinical research on therapeutics.