Use of benzodiazepines for seizure control in kids tied to future risk of polytherapy, reveals study

The present study published in Epilepsia investigated the prevalence of prescription patterns for antiseizure medication for pediatric epilepsy patients in France. The most common antiseizure medicine prescribed was valproate, followed by lamotrigine and levetiracetam. From 2013-2016, there was reduced prevalence of benzodiazepine usage, whereas the prevalence of levetiracetam use increased. Using benzodiazepines increased the likelihood of switching from bitherapy to polytherapy. The usage of benzodiazepines may pose a future risk for polytherapy prescriptions; they highlight

This study described antiseizure medication use in children with epilepsy (CwE) in France, focusing on chronic use of benzodiazepines and related implications.

Researchers conducted a 5-year cohort study from January 2012. They used data from the French national health care data system Children with Epilepsy were identified through the International Classification of Diseases, 10th Revision codes and medications( January 2012 to December 2015; followed them until December 2016) . They described ASMs and assessed whether the risk of initiating a polytherapy after a bitherapy depends on whether benzodiazepine was included in the bitherapy.

Key findings from this study are:

Researchers identified 62 885 Children with Epilepsy.

Valproate was the most reimbursed ASM (40%).

This was followed by lamotrigine, levetiracetam, clobazam, and carbamazepine, which constituted 17.6%, 9.3%, 6.1 %, and 5.8 %, respectively.

Prescriptions were initiated in 74.5% of Children with epilepsy at the hospital.

The number of CwE with at least one benzodiazepine reimbursement decreased from 15.3% to 10.1 % in 2013 and 2016, respectively.

CwE prevalencewith levetiracetam reimbursements increased. On the other hand, the prevalence with valproate decreased.

A switch from a bitherapy to a polytherapy was more likely when the bitherapy included a benzodiazepine with a subdistribution hazard ratio or sHR of 1.20

They concluded that during the study period, CwE prevalence with at least one benzodiazepine reimbursement decreased. Benzodiazepines were also associated with increased use of subsequent ASM polytherapy.

Reference:

Auvin, S., Guillo, S., De Rycke, Y., Tran, D., & Tubach, F. (2024). Benzodiazepines for pediatric epilepsies and their risks in a cohort within the French health care data. Epilepsia. https://doi.org/10.1111/epi.17906