在lamotrigine处方模式和清除中,年龄和性别相关的变异性
Charul Avachat1, Yuhan Long1, Ashley Petersen2
1Experimental & Clinical Pharmacology, University of Minnesota, Minneapolis, Minnesota, USA.
Epilepsia
|February 2, 2026
概括
拉莫特里金的处方和药理动力学因年龄和性别而异. 绝经后妇女的拉莫特里金清除率较低,这表明剂量调整和治疗药物监测对于个性化治疗至关重要.
科学领域:
- 药理学 药理学是指药理学的学科.
- 临床药房 临床药房
- 发病学 (Epileptology) 是一个专业的学科.
背景情况:
- 拉莫是美国广泛使用的抗发作药物 (ASM) 和情绪稳定剂.
- 其有利的副作用,低致性和最小的药物相互作用使其受欢迎.
- 了解其使用中的年龄和性别相关变异性对于优化患者的治疗结果至关重要.
研究的目的:
- 调查拉莫特里金处方模式中的年龄和性别相关差异.
- 在不同的人口群体中分析药物动力学变异性,特别是lamotrigine口服清除率.
- 专注于绝经后妇女,以确定特定的处方和药理动力学趋势.
主要方法:
- 从2015年1月1日到2021年12月31日使用电子健康记录.
- 包括年龄在18岁或以上的个人处方ASM.
- 根据年龄,性别,诊断和单疗法/多疗法,比较了拉莫特里金的处方.
- 采用线性混合效应建模来评估lamotrigine清除率和共变量影响.
主要成果:
- 在314,890人中,有23906人被处方了拉莫.
- 绝经后妇女的处方率低于年轻女性,但高于老年男性.
- 绝经后妇女的拉莫特里金清除率比年轻女性低22%,老年男性的清除率低9%.
- 随着诱导剂 (49%) 或吸烟 (11%),清除增加,随着抑制剂 (51%) 减少.
结论:
- 在和非诊断之间,拉莫特里金的处方率有显著差异.
- 年龄和性别影响拉莫特里金的药理动力学,需要调整剂量.
- 治疗药物监测对于个性化的管理至关重要,特别是在绝经后的妇女中.
- 绝经后的女性比年轻女性和老年男性更少接受拉莫特里金单一治疗.
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