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Rash in Adult and Pediatric Patients Treated with Lamotrigine

Published online by Cambridge University Press:  18 September 2015

John A. Messenheimer
John A. Messenheimer*
Affiliation:
Neurology and Psychiatry Clinical Development,Glaxo Wellcome, Inc
*
Five Moore Drive, PO Box 13398, Research Triangle Park, NC USA 27709
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Abstract:

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Data from clinical trials with lamotrigine indicate that the risk of serious rash in pediatric patients is higher than in adults. The incidence of rash associated with hospitalization among adults treated with lamotrigine is 0.3% and among pediatric patients 1.0%. The incidence of cases reported as possible Stevens-Johnson syndrome is 0.1% for adult patients and 0.5% for pediatric patients. These rates reflect lamotrigine dosing and concomitant AEDs used in these trials, both of which are risk factors for rash. Since many of the trials were conducted prior to the establishment of the current dosing recommendations, the incidence of serious rash in clinical trials does not necessarily reflect the incidence to be expected with use of current dosing recommendations. The higher incidence of serious rash in pediatric patients may at least partially be accounted for by the differential effects of the risk factors of dosing and concomitant use of valproic acid in these patients.

Information

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 25 , Issue S4 , November 1998 , pp. S14 - S18
Copyright
Copyright © Canadian Neurological Sciences Federation 1998

References

1.Roujeau, JC, Kelly, JP, Naldi, L, et al. Medication use and the risk of Stevens-Johnson syndrome or toxic epidermal necrolysis. N Engl J Med 1995; 333: 1600–1607.CrossRefGoogle ScholarPubMed
2.Roujeau, JC, Stern, RS. Severe adverse cutaneous reactions to drugs. N Engl J Med 1994; 331: 1272–1285.CrossRefGoogle ScholarPubMed
3.Assier, H, Bastuji-Garin, S, Revuz, J, Roujeau, JC. Erythema multiforme with mucous membrane involvement and Stevens–Johnson syndrome are clinically different disorders with distinct causes. Arch Dermatol 1995; 131: 539–543.CrossRefGoogle ScholarPubMed
4.Revuz, J, Penso, D, Roujeau, JC, et al, Toxic epidermal necrolysis. Clinical findings and prognosis factors in 87 patients. Arch Dermatol 1995; 123: 1160–1165.CrossRefGoogle Scholar
5.Shear, NH, Spielberg, SP. Anticonvulsant hypersensitivity syndrome. An in-vitro assessment of risk. J Clinical Invest 1988; 82: 1826–1832.CrossRefGoogle ScholarPubMed
6.Chan, HL, Stern, RS, Arndt, K, et al. The incidence of erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis. Arch Dermatology 1990; 126: 43–47.CrossRefGoogle ScholarPubMed
7.Chattergoon, DS, McGuigan, MA, Koren, G, Hwang, P, Ito, S. Multiorgan dysfunction and disseminated intravascular coagulation in children receiving lamotrigine and valproic acid. Neurology 1997; 19: 1442–1444.CrossRefGoogle Scholar
8.Mackay, FJ, Wilton, LV, Pearce, GL, Freemantle, SN, Mann, RD. Safety of long-term lamotrigine in epilepsy. Epilepsia 1997; 38: 881–886.CrossRefGoogle ScholarPubMed
9.Tennis, P, Stern, R. A Saskatchewan record linkage study on the risk of hospitalizations for serious cutaneous disorders occurring after initiation of use of phenytoin, carbamazepine, and sodium valproate. Neurology 1997; 49: 1–5.CrossRefGoogle ScholarPubMed
10.Konishi, T, Naganuma, Y, Hongo, K, et al. Carbamazepine-induced skin rash in children with epilepsy. Euro J Pediatrics 1993; 152: 605–608.CrossRefGoogle ScholarPubMed
11.Chadwick, D, Shaw, MDM, Foy, P, Rawlins, MD, Turnbull, DM. Serum anticonvulsant concentrations and the risk of drug induced skin eruptions. J Neurol Neurosurg Psychiatry 1984; 47: 642–644.CrossRefGoogle ScholarPubMed
12.Wilson, JT, Hojer, B, Tomson, G, Rane, A, Sjoqvist, F. High incidence of a concentration dependent skin reaction in children treated with phenytoin. Br Med J 1978; 1(6127): 1583–1586.CrossRefGoogle ScholarPubMed
13.Rzany, B, Mockenhaupt, M, Baur, S, et al. Epidemiology of erythema exsudativum multiforme majus, Stevens-Johnson syndrome, and toxic epidermal necrolysis in Germany (1990-1992): structure and results of a population-based registry. J Clin Epidemiol 1996; 49: 769–773.CrossRefGoogle ScholarPubMed