{"id":590969,"date":"2026-09-05T12:24:09","date_gmt":"2026-09-05T12:24:09","guid":{"rendered":"https:\/\/www.newsbeep.com\/nz\/590969\/"},"modified":"2026-09-05T12:24:09","modified_gmt":"2026-09-05T12:24:09","slug":"antiseizure-drugs-affect-anticoagulant-safety-emj","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/nz\/590969\/","title":{"rendered":"Antiseizure Drugs Affect Anticoagulant Safety \u2013 EMJ"},"content":{"rendered":"<p><a href=\"https:\/\/www.emjreviews.com\/hematology\/news\/direct-oral-anticoagulants-lower-venous-thromboembolism-recurrence-risk\/\" rel=\"nofollow noopener\" target=\"_blank\">DIRECT ORAL ANTICOAGULANTS<\/a>\u00a0in adults with epilepsy were associated with different thromboembolic, bleeding, and mortality outcomes depending on the antiseizure medication used, according to a large retrospective cohort study.\u00a0<\/p>\n<p>Researchers evaluated the comparative safety of commonly prescribed antiseizure medications in adults receiving direct oral anticoagulants.\u00a0<\/p>\n<p>Using data from an international electronic health record network, the team emulated a target trial and compared levetiracetam, valproate, moderate enzyme inducing antiseizure medications, and strong enzyme inducing antiseizure medications against a pooled reference group receiving lamotrigine or lacosamide.\u00a0<\/p>\n<p>From 2.29 million adults with\u00a0<a href=\"https:\/\/www.emjreviews.com\/flagship-journal\/article\/predictors-of-medication-adherence-and-quality-of-life-among-patients-with-epilepsy-in-nigeria-j19123\/\" rel=\"nofollow noopener\" target=\"_blank\">epilepsy<\/a>, 40,932 were eligible for direct oral anticoagulant treatment. A total of 9,529 treatment initiators were included\u00a0in the final analysis. The mean age was 63 years, and 51% were female.\u00a0<\/p>\n<p>Higher Thromboembolic Risk Observed\u00a0<\/p>\n<p>In matched analyses, levetiracetam was associated with a greater risk of thromboembolic events compared with lamotrigine or lacosamide.\u00a0It was also associated with increased\u00a0all-cause\u00a0mortality.\u00a0Major bleeding risk was comparable between groups.\u00a0<\/p>\n<p>Strong enzyme inducing antiseizure medications, including carbamazepine and phenytoin, were likewise associated with higher thromboembolic risk.\u00a0However, these therapies were linked to a lower risk of major bleeding.\u00a0<\/p>\n<p>The investigators estimated that\u00a0approximately 28%\u00a0of thromboembolic events may have been preventable if outcomes had matched those\u00a0observed\u00a0in the lamotrigine or lacosamide reference group.\u00a0<\/p>\n<p>Mortality and Bleeding Concerns\u00a0with\u00a0Valproate\u00a0<\/p>\n<p>Valproate showed a distinct risk profile. Compared with the reference group, valproate was associated with higher\u00a0all-cause\u00a0mortality,\u00a0as well as a greater risk of intracranial major bleeding.\u00a0<\/p>\n<p>Notably, among adults treated with vitamin K antagonists, thromboembolic risks were reported to be near null.\u00a0\u00a0<\/p>\n<p>The authors concluded that antiseizure medication choice\u00a0represents\u00a0a potentially modifiable factor influencing outcomes in adults with epilepsy receiving direct oral anticoagulants, highlighting the importance of treatment selection when balancing thromboembolic and bleeding risks.\u00a0<\/p>\n<p>Reference\u00a0<\/p>\n<p>Schubert KM\u00a0et al. Safety of Antiseizure Medications During Direct Oral Anticoagulant Therapy in Epilepsy. JAMA Neurol.\u00a02026;DOI:10.1001\/jamaneurol.2026.2712\u00a0<\/p>\n<p>Featured\u00a0image:\u00a0mjowra\u00a0on\u00a0Adobe Stock\u00a0<\/p>\n","protected":false},"excerpt":{"rendered":"DIRECT ORAL ANTICOAGULANTS\u00a0in adults with epilepsy were associated with different thromboembolic, bleeding, and mortality outcomes depending on the&hellip;\n","protected":false},"author":2,"featured_media":590970,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[10],"tags":[134,111,139,69],"class_list":["post-590969","post","type-post","status-publish","format-standard","has-post-thumbnail","category-health","tag-health","tag-new-zealand","tag-newzealand","tag-nz"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts\/590969","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/comments?post=590969"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts\/590969\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/media\/590970"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/media?parent=590969"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/categories?post=590969"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/tags?post=590969"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}