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Article: Factors influencing the incidence of lamotrigine-related skin rash

TitleFactors influencing the incidence of lamotrigine-related skin rash
Authors
KeywordsEpilepsy
Lamotrigine
Pharmacoepidemiology
Rash
Issue Date1999
PublisherHarvey Whitney Books Company. The Journal's web site is located at http://www.theannals.com
Citation
Annals Of Pharmacotherapy, 1999, v. 33 n. 10, p. 1037-1042 How to Cite?
AbstractOBJECTIVE: To determine the incidences of serious and nonserious lamotrigine-related rash, determine the risk factors for lamotrigine-related rash, and evaluate the impact on the incidence of rash of the manufacturer's recommendation to reduce the starting dose of lamotrigine. METHODS: This was a retrospective case record survey at five tertiary referral epilepsy centers in the UK. The risk factors for lamotrigine-related rash were identified by logistic regression. The independent factors tested were gender, age, epilepsy type, concurrent medication, and starting dose of lamotrigine. The incidences of rash before and after the recommendation of reduction in starting dose were compared by χ 2 analysis. RESULTS: A total of 1050 patients were included. The incidences of serious and nonserious rash were 1.1% (95% CI 0.5% to 1.8%) and 7% (95% CI 5.5% to 8.6%), respectively. Females were at higher risk of developing rash than were males, with a relative risk of 1.8 (95% CI 1.2 to 2.8). The starting dose of lamotrigine was reduced in response to the manufacturer's recommendation, and there was a significant reduction (p = 0.045) in the incidence of serious rash, from 1.5% (12/805) to 0% (0/245). However, there was no reduction in the overall incidence of lamotrigine-related rash, with 63/805 (8%) before and 23/245 (9%) after the recommendation. CONCLUSIONS: Failure to detect a reduction in the incidence of lamotrigine-related rash since the new (reduced) recommended starting dose of lamotrigine may arise from failure to reduce the starting dose below a critical threshold level, incomplete compliance with current recommendations, or insufficient sample size. The results of this and other studies show that the starting dose of lamotrigine is a significant factor affecting the incidence of rash; furthermore, this study also shows that significant reduction in the incidence of serious rash can be achieved by reducing the starting dose. Therefore, clinicians should not deviate from the recommendations.
Persistent Identifierhttp://hdl.handle.net/10722/132920
ISSN
2023 Impact Factor: 2.3
2023 SCImago Journal Rankings: 0.779
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorWong, ICKen_HK
dc.contributor.authorMawer, GEen_HK
dc.contributor.authorSander, JWASen_HK
dc.date.accessioned2011-04-04T07:57:59Z-
dc.date.available2011-04-04T07:57:59Z-
dc.date.issued1999en_HK
dc.identifier.citationAnnals Of Pharmacotherapy, 1999, v. 33 n. 10, p. 1037-1042en_HK
dc.identifier.issn1060-0280en_HK
dc.identifier.urihttp://hdl.handle.net/10722/132920-
dc.description.abstractOBJECTIVE: To determine the incidences of serious and nonserious lamotrigine-related rash, determine the risk factors for lamotrigine-related rash, and evaluate the impact on the incidence of rash of the manufacturer's recommendation to reduce the starting dose of lamotrigine. METHODS: This was a retrospective case record survey at five tertiary referral epilepsy centers in the UK. The risk factors for lamotrigine-related rash were identified by logistic regression. The independent factors tested were gender, age, epilepsy type, concurrent medication, and starting dose of lamotrigine. The incidences of rash before and after the recommendation of reduction in starting dose were compared by χ 2 analysis. RESULTS: A total of 1050 patients were included. The incidences of serious and nonserious rash were 1.1% (95% CI 0.5% to 1.8%) and 7% (95% CI 5.5% to 8.6%), respectively. Females were at higher risk of developing rash than were males, with a relative risk of 1.8 (95% CI 1.2 to 2.8). The starting dose of lamotrigine was reduced in response to the manufacturer's recommendation, and there was a significant reduction (p = 0.045) in the incidence of serious rash, from 1.5% (12/805) to 0% (0/245). However, there was no reduction in the overall incidence of lamotrigine-related rash, with 63/805 (8%) before and 23/245 (9%) after the recommendation. CONCLUSIONS: Failure to detect a reduction in the incidence of lamotrigine-related rash since the new (reduced) recommended starting dose of lamotrigine may arise from failure to reduce the starting dose below a critical threshold level, incomplete compliance with current recommendations, or insufficient sample size. The results of this and other studies show that the starting dose of lamotrigine is a significant factor affecting the incidence of rash; furthermore, this study also shows that significant reduction in the incidence of serious rash can be achieved by reducing the starting dose. Therefore, clinicians should not deviate from the recommendations.en_HK
dc.languageengen_US
dc.publisherHarvey Whitney Books Company. The Journal's web site is located at http://www.theannals.comen_HK
dc.relation.ispartofAnnals of Pharmacotherapyen_HK
dc.subjectEpilepsyen_HK
dc.subjectLamotrigineen_HK
dc.subjectPharmacoepidemiologyen_HK
dc.subjectRashen_HK
dc.titleFactors influencing the incidence of lamotrigine-related skin rashen_HK
dc.typeArticleen_HK
dc.identifier.emailWong, ICK: wongick@hku.hken_HK
dc.identifier.authorityWong, ICK=rp01480en_HK
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1345/aph.18422en_HK
dc.identifier.pmid10534214-
dc.identifier.scopuseid_2-s2.0-0032860571en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0032860571&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume33en_HK
dc.identifier.issue10en_HK
dc.identifier.spage1037en_HK
dc.identifier.epage1042en_HK
dc.identifier.isiWOS:000083211900003-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridWong, ICK=7102513915en_HK
dc.identifier.scopusauthoridMawer, GE=7004053826en_HK
dc.identifier.scopusauthoridSander, JWAS=7202898360en_HK
dc.identifier.issnl1060-0280-

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