Lamotrigine clearance increases by 5 weeks gestational age: Relationship to estradiol concentrations and gestational age

Annals of Neurology
Ashwin KaranamAngela K Birnbaum

Abstract

To determine how early lamotrigine clearance (LTG-CL/F) increases during early pregnancy in women with epilepsy and to quantify the relationship of LTG-CL/F to estradiol concentrations and gestational week. This was a multicenter, observational study of pregnant women with epilepsy on lamotrigine and no interacting concomitant medications, employing frequent blood sampling prior to and early in pregnancy. A population mixed-effects modeling approach was used to describe the relationship between LTG-CL/F and gestational week and between LTG-CL/F and estradiol. Akaike information criterion (AIC) compared goodness of fit between final models and a generalized estimating equation to compare differences between low and high percentage LTG-CL/F change groups (p < 0.05). Twenty-five pregnancies (22 participants) were available. Increases in LTG-CL/F were present at 5 weeks gestational age. Both estradiol and gestational week were highly correlated with LTG-CL/F changes; LTG-CL/F increased at the rate of 0.115l/h for every gestational week and 0.844l/h for every 1ng/ml of estradiol, with women in the high LTG-CL/F percentage change group changing at a faster rate (p < 0.001). Models using gestational week performed better than models u...Continue Reading

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Citations

Dec 31, 2019·JAMA Neurology·Angela K BirnbaumUNKNOWN MONEAD Investigator Group
Mar 11, 2020·Seminars in Perinatology·Crystal T Clark
Apr 16, 2021·Pharmacological Research : the Official Journal of the Italian Pharmacological Society·Ming-Lu WangLimei Zhao

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