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Zonisamide serum concentrations during pregnancy

Reimers, Arne LU orcid ; Helde, Grethe ; Becser Andersen, Noémi ; Aurlien, Dag ; Surlien Navjord, Elisabeth ; Haggag, Kathrine ; Christensen, Jakob LU ; Lillestølen, Kari Mette ; Nakken, Karl Otto and Brodtkorb, Eylert (2018) In Epilepsy Research 144. p.25-29
Abstract

Purpose: To investigate the change in zonisamide (ZNS) serum concentration and its consequences in pregnant women with epilepsy. Methods: Six hospitals in Norway and Denmark screened their records for women who had been using ZNS during pregnancy. Absolute serum concentrations as well as concentration/dose (CD)-ratios were compared to non-pregnant values. Descriptive data on seizure control and obstetrical data were also collected. Results: 144 serum concentrations from 23 pregnancies in 15 individual women with epilepsy were included (six on monotherapy). The mean ZNS serum concentration fell to a minimum of 58.6 ± 15.1%, while the C/D-ratio fell to as low as 55.1 ± 15.3% of the non-pregnant-value. The lowest values were seen in... (More)

Purpose: To investigate the change in zonisamide (ZNS) serum concentration and its consequences in pregnant women with epilepsy. Methods: Six hospitals in Norway and Denmark screened their records for women who had been using ZNS during pregnancy. Absolute serum concentrations as well as concentration/dose (CD)-ratios were compared to non-pregnant values. Descriptive data on seizure control and obstetrical data were also collected. Results: 144 serum concentrations from 23 pregnancies in 15 individual women with epilepsy were included (six on monotherapy). The mean ZNS serum concentration fell to a minimum of 58.6 ± 15.1%, while the C/D-ratio fell to as low as 55.1 ± 15.3% of the non-pregnant-value. The lowest values were seen in gestational months six to nine, and the individual nadir varied considerably (range: 24–81% of the non-pregnant value). Four out of ten previously seizure-free patients experienced breakthrough seizures. Gestational age, weight at birth and head circumference of the newborns were within the reference ranges. Conclusions: ZNS serum concentrations may fall by over 40% during pregnancy, with large interindividual variability. In some patients, this may lead to worsened seizure control. These findings are in line with reports on other AEDs and suggest that regular therapeutic drug monitoring and dose adjustments may be useful.

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author
; ; ; ; ; ; ; ; and
publishing date
type
Contribution to journal
publication status
published
keywords
Antiepileptic drug, Elimination, Epilepsy, Pharmacokinetics, Pregnancy, Serum concentration, Zonisamide
in
Epilepsy Research
volume
144
pages
25 - 29
publisher
Elsevier
external identifiers
  • pmid:29751353
  • scopus:85046632294
ISSN
0920-1211
DOI
10.1016/j.eplepsyres.2018.05.002
language
English
LU publication?
no
additional info
Publisher Copyright: © 2018 Elsevier B.V.
id
ecb7c116-37e5-48c8-9037-5da4fc0059b4
date added to LUP
2024-08-31 14:41:17
date last changed
2025-02-16 07:55:01
@article{ecb7c116-37e5-48c8-9037-5da4fc0059b4,
  abstract     = {{<p>Purpose: To investigate the change in zonisamide (ZNS) serum concentration and its consequences in pregnant women with epilepsy. Methods: Six hospitals in Norway and Denmark screened their records for women who had been using ZNS during pregnancy. Absolute serum concentrations as well as concentration/dose (CD)-ratios were compared to non-pregnant values. Descriptive data on seizure control and obstetrical data were also collected. Results: 144 serum concentrations from 23 pregnancies in 15 individual women with epilepsy were included (six on monotherapy). The mean ZNS serum concentration fell to a minimum of 58.6 ± 15.1%, while the C/D-ratio fell to as low as 55.1 ± 15.3% of the non-pregnant-value. The lowest values were seen in gestational months six to nine, and the individual nadir varied considerably (range: 24–81% of the non-pregnant value). Four out of ten previously seizure-free patients experienced breakthrough seizures. Gestational age, weight at birth and head circumference of the newborns were within the reference ranges. Conclusions: ZNS serum concentrations may fall by over 40% during pregnancy, with large interindividual variability. In some patients, this may lead to worsened seizure control. These findings are in line with reports on other AEDs and suggest that regular therapeutic drug monitoring and dose adjustments may be useful.</p>}},
  author       = {{Reimers, Arne and Helde, Grethe and Becser Andersen, Noémi and Aurlien, Dag and Surlien Navjord, Elisabeth and Haggag, Kathrine and Christensen, Jakob and Lillestølen, Kari Mette and Nakken, Karl Otto and Brodtkorb, Eylert}},
  issn         = {{0920-1211}},
  keywords     = {{Antiepileptic drug; Elimination; Epilepsy; Pharmacokinetics; Pregnancy; Serum concentration; Zonisamide}},
  language     = {{eng}},
  pages        = {{25--29}},
  publisher    = {{Elsevier}},
  series       = {{Epilepsy Research}},
  title        = {{Zonisamide serum concentrations during pregnancy}},
  url          = {{http://dx.doi.org/10.1016/j.eplepsyres.2018.05.002}},
  doi          = {{10.1016/j.eplepsyres.2018.05.002}},
  volume       = {{144}},
  year         = {{2018}},
}