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In “Reducing birth defects in women with epilepsy: research leading to results,” Pennell and Meador discuss: (1) the need for neurologists to carefully consider selection of antiepileptic drugs (AEDs) in women of childbearing age and (2) the impact of EURAP—a prospective registry of women on AEDs in 42 countries—on facilitating further understanding of the risks of congenital malformations and neurodevelopmental abnormalities associated with AEDs. Braillon and Bewley comment that (1) increased advocacy is needed to ensure whether EURAP's findings affect practice expediently and (2) to make the results more meaningful, EURAP should include detailed data on other risk factors for congenital malformations and neurodevelopmental abnormalities. Finally, the findings of EURAP should have influence on regulatory agencies to improve drug safety. Sethi further notes that it is particularly important for steps to be taken to ensure whether EURAP's findings be used to improve AED prescribing practices in low- and middle-income countries. Pennell and Meador respond that it is challenging to change practice, but partnership with governmental and regulatory organizations and performance of meta-analyses can help disseminate information about medications associated with of congenital malformations and neurodevelopmental abnormalities. Pennell further notes that the International League against Epilepsy is working to facilitate education of all specialists who care for women with epilepsy using knowledge acquired from EURAP in an effort to decrease the frequency of congenital malformations and neurodevelopmental abnormalities in patients on AEDs.
In “Reducing birth defects in women with epilepsy: research leading to results,” Pennell and Meador discuss: (1) the need for neurologists to carefully consider selection of antiepileptic drugs (AEDs) in women of childbearing age and (2) the impact of EURAP—a prospective registry of women on AEDs in 42 countries—on facilitating further understanding of the risks of congenital malformations and neurodevelopmental abnormalities associated with AEDs. Braillon and Bewley comment that (1) increased advocacy is needed to ensure whether EURAP's findings affect practice expediently and (2) to make the results more meaningful, EURAP should include detailed data on other risk factors for congenital malformations and neurodevelopmental abnormalities. Finally, the findings of EURAP should have influence on regulatory agencies to improve drug safety. Sethi further notes that it is particularly important for steps to be taken to ensure whether EURAP's findings be used to improve AED prescribing practices in low- and middle-income countries. Pennell and Meador respond that it is challenging to change practice, but partnership with governmental and regulatory organizations and performance of meta-analyses can help disseminate information about medications associated with of congenital malformations and neurodevelopmental abnormalities. Pennell further notes that the International League against Epilepsy is working to facilitate education of all specialists who care for women with epilepsy using knowledge acquired from EURAP in an effort to decrease the frequency of congenital malformations and neurodevelopmental abnormalities in patients on AEDs.
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Author disclosures are available upon request (journal{at}neurology.org).
- © 2020 American Academy of Neurology
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