Stiripentol/valproate

Stiripentol/valproate Reactions 1704, p348 - 2 Jun 2018 Worsening of absence seizures, myoclonus and recurrent pancreatitis: 2 case reports In a prospective, open-label observational study of 41 patients, one patient developed myoclonus and worsening of absence seizures on stiripentol and one patient developed recurrent pancreatitis on treatment with valproate and stiripentol [ages, sexes, routes and dosages not stated, not all durations of treatments to reactions onsets stated]. Patient 1: The patient had Dravet syndrome and received treatment with stiripentol. Additionally, the patient was receiving other unspecified antiepileptic medication. The stiripentol dose was gradually increased; however, at increased doses the patient developed myoclonus along with transient worsening of absence seizures. The patient continued taking stiripentol due to it’s beneficial effects on the tonic-clonic seizures. Patient 2: The patient had Dravet syndrome and had been receiving valproate since the age of 8 months. At the age of three years, the patient started receiving stiripentol. Two months after starting stiripentol, the patient developed an episode of pancreatitis. Over the next two years, the patient developed 10 such episodes. The episodes involved abdominal pain and vomiting, with serum lipase rising upto 7000 units per litre and returning to normal between attacks. The patient’s valproate levels were between 542–677 µmol/L (reference range 350–700 µmol/L) during the episodes. The patient’s therapy with stiripentol was stopped. However, the patient again developed an episode of pancreatitis. Consequently, valproate was stopped and stiripentol was re- started with no further episodes of pancreatitis. Both valproate and stiripentol were associated with the development of pancreatitis. Author comment: "One patient reported transient worsening of absence seizures and myoclonus with [stiripentol] dose increases." "Although rare, recurrent pancreatitis can be associated with stiripentol therapy when added to valproate. Stiripentol was then restarted, and valproate weaned, after which there were no further episodes of pancreatitis, implicating valproate in its causation." Myers KA, et al. Stiripentol efficacy and safety in Dravet syndrome: a 12-year observational study. Developmental Medicine and Child Neurology 60: 574-578, No. 6, Jun 2018. Available from: URL: http://doi.org/10.1111/dmcn.13704 - Australia 803323811 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Reactions Weekly Springer Journals

Stiripentol/valproate

Reactions Weekly , Volume 1704 (1) – Jun 2, 2018
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Publisher
Springer International Publishing
Copyright
Copyright © 2018 by Springer International Publishing AG, part of Springer Nature
Subject
Medicine & Public Health; Drug Safety and Pharmacovigilance; Pharmacology/Toxicology
ISSN
0114-9954
eISSN
1179-2051
D.O.I.
10.1007/s40278-018-46991-x
Publisher site
See Article on Publisher Site

Abstract

Reactions 1704, p348 - 2 Jun 2018 Worsening of absence seizures, myoclonus and recurrent pancreatitis: 2 case reports In a prospective, open-label observational study of 41 patients, one patient developed myoclonus and worsening of absence seizures on stiripentol and one patient developed recurrent pancreatitis on treatment with valproate and stiripentol [ages, sexes, routes and dosages not stated, not all durations of treatments to reactions onsets stated]. Patient 1: The patient had Dravet syndrome and received treatment with stiripentol. Additionally, the patient was receiving other unspecified antiepileptic medication. The stiripentol dose was gradually increased; however, at increased doses the patient developed myoclonus along with transient worsening of absence seizures. The patient continued taking stiripentol due to it’s beneficial effects on the tonic-clonic seizures. Patient 2: The patient had Dravet syndrome and had been receiving valproate since the age of 8 months. At the age of three years, the patient started receiving stiripentol. Two months after starting stiripentol, the patient developed an episode of pancreatitis. Over the next two years, the patient developed 10 such episodes. The episodes involved abdominal pain and vomiting, with serum lipase rising upto 7000 units per litre and returning to normal between attacks. The patient’s valproate levels were between 542–677 µmol/L (reference range 350–700 µmol/L) during the episodes. The patient’s therapy with stiripentol was stopped. However, the patient again developed an episode of pancreatitis. Consequently, valproate was stopped and stiripentol was re- started with no further episodes of pancreatitis. Both valproate and stiripentol were associated with the development of pancreatitis. Author comment: "One patient reported transient worsening of absence seizures and myoclonus with [stiripentol] dose increases." "Although rare, recurrent pancreatitis can be associated with stiripentol therapy when added to valproate. Stiripentol was then restarted, and valproate weaned, after which there were no further episodes of pancreatitis, implicating valproate in its causation." Myers KA, et al. Stiripentol efficacy and safety in Dravet syndrome: a 12-year observational study. Developmental Medicine and Child Neurology 60: 574-578, No. 6, Jun 2018. Available from: URL: http://doi.org/10.1111/dmcn.13704 - Australia 803323811 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704

Journal

Reactions WeeklySpringer Journals

Published: Jun 2, 2018

References

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