Associations between antiepileptic use and hypogammaglobulinaemia: findings from a population-based case-control study using data linkage

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Abstract

Background Antiepileptic drugs (AEDs) have been previously associated with transient hypogammaglob- ulinaemia in small case series, which may predispose patients to infections. This study aimed to determine if an association exists between AEDs and hypogammaglobulinaemia.

Methods A case-control study was conducted using data linkage of biochemistry, prescribing and morbidity data from 2009-2021. Cases were participants with immunoglobulin levels less than the normal range. Logistic regression was used to investigate associations between AED exposure and hypogamma- globulinaemia, adjusting for age and sex. Secondary analyses were conducted, investigating outcomes of low IgA, IgM and IgG separately. Cumulative exposure data were used to determine whether a exposure-response relationship exists.

Results 18,666 cases and 127,157 controls were identified. AEDs were associated with increased risk of hypogammaglobulinaemia (adjusted odds ratio (aOR) 1.26 (95% confidence interval 1.21-1.31), p<0.001). Individual AEDs (except topiramate) were also associated with significantly increased hypogammaglob- ulinaemia risk to varying degrees. There was evidence of an exposure-response relationship for those treated with any AED.

Conclusion AEDs may increase hypogammaglobulinaemia risk. Specific classes of immunoglobulins are differentially affected, and risk may increase with AED exposure. Clinicians should test immunoglobulin levels if unusual or recurrent infections occur. Further research should assess whether AED-associated hypogammaglobulinaemia increases infection risk.
Original languageEnglish
Article numbere2
Number of pages1
JournalJournal of Neurology, Neurosurgery & Psychiatry
Volume93
DOIs
Publication statusPublished - Sep 2022
EventAssociation of British Neurologists -
Duration: 20 May 2022 → …

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