Comparison of antiepileptic drug prescribing in children in three European countries.
OBJECTIVE
Antiepileptic drug (AED) use in young people is increasing. However, evidence of its use at a multinational level is limited. This study aims to characterize AED prescribing in the young in three European countries and to assess the capacity of drug safety surveillance.


METHODS
A retrospective cohort study was conducted in 2001-2005 using primary care databases: PEDIANET (Italy, 0-11 years), IPCI (The Netherlands, 0-18 years), and IMS Disease Analyzer (United Kingdom, 0-18 years). Prescribing prevalence was calculated by country, patient age, and drug type.


RESULTS
In 2005, AED prevalence in children (0-11 years) was highest in Italy [3.9 subjects/1,000 person-years (PY)] followed by the United Kingdom (3.0 subjects/1,000 PY) and The Netherlands (2.2 subjects/1,000 PY). Over the study period, prescribing prevalence in 0-11 year olds was stable in all countries. In contrast, a steady rise of AED prevalence was observed in adolescents (12-18 years) in the United Kingdom (p = 0.0003) but not in The Netherlands (p = 0.88). All countries showed a slight increase in prevalence for newer AEDs. Simultaneously, the prevalence of conventional AEDs decreased in The Netherlands and Italy, but not in the United Kingdom. In 2005, lamotrigine use was highest in The Netherlands and the United Kingdom, whereas topiramate was favored in Italy.


CONCLUSIONS
In Europe, conventional AEDs are still the main treatment choice for children with epilepsy, and the use of newer AEDs remains low. Our study highlights a lack of research capacity to conduct multinational AED safety studies in children. Further work should explore large databases and other health care settings to meet these research needs.
Hsia
Yingfen
Y
Centre for Paediatric Pharmacy Research, The School of Pharmacy, University of London and Institute of Child Health, University College London, London, United Kingdom. yingfen.hsia@pharmacy.ac.uk
Neubert
Antje
A
Sturkenboom
Miriam C J M
MC
Murray
Macey L
ML
Verhamme
Katia M C
KM
Sen
Fatma
F
Giaquinto
Carlo
C
Ceci
Adriana
A
Wong
Ian C K
IC
D000293:Adolescent; D000367:Age Factors; D000927:Anticonvulsants / Q000627:therapeutic use*; D002648:Child; D015331:Cohort Studies; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004363:Drug Utilization; D004827:Epilepsy / Q000188:drug therapy*; D005260:Female; D005632:Fructose / Q000031:analogs & derivatives / Q000627:therapeutic use; D019538:Health Care Surveys; D006801:Humans; D007558:Italy; D000077213:Lamotrigine; D008297:Male; D009426:Netherlands; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies; D000077236:Topiramate; D014227:Triazines / Q000627:therapeutic use; D006113:United Kingdom
D000927:Anticonvulsants; D014227:Triazines; D000077236:Topiramate; D005632:Fructose; D000077213:Lamotrigine