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Cancer incidence among patients using antiepileptic drugs: a long-term follow-up of 28,000 patients.
Eur J Clin Pharmacol. 2002 May; 58(2):137-41.EJ

Abstract

OBJECTIVES

The purpose of the study was to find out whether there is an association between use of enzyme-inducing antiepileptic medicines and cancer.

METHODS

: A cohort of 14,487 male and 13,932 female patients who received reimbursement for antiepileptic drugs (AEDs) in 1979-1981 in Finland was followed for subsequent cancers up to 1997 through the Finnish Cancer Registry.

RESULTS

During the follow-up, 2242 cancer cases were observed, while the expected number based on national incidence rates was 1743. Over 40% of the excess was attributable to cancer of the brain and nervous system [standardised incidence ratio (SIR) 4.30, 95% confidence interval (CI) 3.81, 4.82]. The relative risk of meningiomas was very high (SIR 46.6, 95% CI 22.3, 85.6) only during the first year of reimbursement, while the risk of gliomas remained tenfold or higher for 7 years and was significantly increased for 19 years in patients taking AEDs. Also cancers of the larynx (SIR 1.77), liver (1.71), pancreas (1.35), colon (1.32), stomach (1.30) and lung (1.29) showed statistically increased risks.

CONCLUSION

As epilepsy can be a symptom of cancers of the nervous system, the role of AEDs in their occurrence is speculative albeit possible. The excess of some cancers might be attributable to enzyme-inducing antiepileptic drugs, but the excess is not very high compared with the benefits obtained with these drugs.

Authors+Show Affiliations

Orton Hospital, Tenholantie 10, 00280 Helsinki, Finland. anne.lamminpaa@invalidisaatio.fiNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12012147

Citation

Lamminpää, Anne, et al. "Cancer Incidence Among Patients Using Antiepileptic Drugs: a Long-term Follow-up of 28,000 Patients." European Journal of Clinical Pharmacology, vol. 58, no. 2, 2002, pp. 137-41.
Lamminpää A, Pukkala E, Teppo L, et al. Cancer incidence among patients using antiepileptic drugs: a long-term follow-up of 28,000 patients. Eur J Clin Pharmacol. 2002;58(2):137-41.
Lamminpää, A., Pukkala, E., Teppo, L., & Neuvonen, P. J. (2002). Cancer incidence among patients using antiepileptic drugs: a long-term follow-up of 28,000 patients. European Journal of Clinical Pharmacology, 58(2), 137-41.
Lamminpää A, et al. Cancer Incidence Among Patients Using Antiepileptic Drugs: a Long-term Follow-up of 28,000 Patients. Eur J Clin Pharmacol. 2002;58(2):137-41. PubMed PMID: 12012147.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cancer incidence among patients using antiepileptic drugs: a long-term follow-up of 28,000 patients. AU - Lamminpää,Anne, AU - Pukkala,Eero, AU - Teppo,Lyly, AU - Neuvonen,Pertti J, Y1 - 2002/03/21/ PY - 2001/04/05/received PY - 2002/5/16/pubmed PY - 2002/11/28/medline PY - 2002/5/16/entrez SP - 137 EP - 41 JF - European journal of clinical pharmacology JO - Eur J Clin Pharmacol VL - 58 IS - 2 N2 - OBJECTIVES: The purpose of the study was to find out whether there is an association between use of enzyme-inducing antiepileptic medicines and cancer. METHODS: : A cohort of 14,487 male and 13,932 female patients who received reimbursement for antiepileptic drugs (AEDs) in 1979-1981 in Finland was followed for subsequent cancers up to 1997 through the Finnish Cancer Registry. RESULTS: During the follow-up, 2242 cancer cases were observed, while the expected number based on national incidence rates was 1743. Over 40% of the excess was attributable to cancer of the brain and nervous system [standardised incidence ratio (SIR) 4.30, 95% confidence interval (CI) 3.81, 4.82]. The relative risk of meningiomas was very high (SIR 46.6, 95% CI 22.3, 85.6) only during the first year of reimbursement, while the risk of gliomas remained tenfold or higher for 7 years and was significantly increased for 19 years in patients taking AEDs. Also cancers of the larynx (SIR 1.77), liver (1.71), pancreas (1.35), colon (1.32), stomach (1.30) and lung (1.29) showed statistically increased risks. CONCLUSION: As epilepsy can be a symptom of cancers of the nervous system, the role of AEDs in their occurrence is speculative albeit possible. The excess of some cancers might be attributable to enzyme-inducing antiepileptic drugs, but the excess is not very high compared with the benefits obtained with these drugs. SN - 0031-6970 UR - https://www.unboundmedicine.com/medline/citation/12012147/Cancer_incidence_among_patients_using_antiepileptic_drugs:_a_long_term_follow_up_of_28000_patients_ L2 - https://dx.doi.org/10.1007/s00228-002-0429-6 DB - PRIME DP - Unbound Medicine ER -