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Predictors of Lamotrigine-associated rash
Lawrence J Hirsch1, David B Weintraub, Richard Buchsbaum
1Comprehensive Epilepsy Center, Department of Neurology, Mailman School of Public Health, Columbia University, 710 W. 168th Street, NI-1-35, New York, NY 10032, U.S.A. ljh3@columbia.edu
Epilepsia
|February 28, 2006
Summary
A history of rash from other antiepileptic drugs (AEDs) and younger age (under 13) are key predictors of lamotrigine-associated rash (LTG-rash). Severe LTG-rash is rare with proper titration.
Area of Science:
- Neurology
- Pharmacology
- Dermatology
Background:
- Lamotrigine (LTG) is a widely used antiepileptic drug (AED).
- Drug-associated rashes are a known concern with LTG, necessitating risk assessment.
- Identifying predictors of LTG-rash is crucial for patient safety and individualized treatment.
Purpose of the Study:
- To identify predictors of lamotrigine-associated rash (LTG-rash).
- To determine the incidence of serious and benign LTG-rash.
- To aid in individualized risk assessment for patients initiating LTG therapy.
Main Methods:
- Retrospective chart review of 988 outpatients receiving LTG.
- Analysis of demographics, medical history, and medication variables.
- Statistical testing for predictors of LTG-rash.
Main Results:
- 5.7% of patients developed LTG-rash; 3.9% discontinued LTG due to rash.
- A history of rash from another AED was the strongest predictor (OR=3.62, p<0.001).
- Children younger than 13 years had a higher incidence of LTG-rash (OR=2.77, p<0.001).
- Severe rashes like Stevens-Johnson syndrome or toxic epidermal necrolysis were rare.
Conclusions:
- A prior AED-related rash is the most significant risk factor for LTG-rash.
- Age under 13 is also a risk factor for developing LTG-rash.
- Serious LTG-rash is infrequent when using recommended titration rates.
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