{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T05:54:57Z","timestamp":1793253297644,"version":"4.5.0"},"reference-count":14,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2016,6,20]],"date-time":"2016-06-20T00:00:00Z","timestamp":1466380800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003769","name":"Eisai","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003769","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004330","name":"GlaxoSmithKline","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004330","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004336","name":"Novartis","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004336","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004348","name":"Stockholms L\u00e4ns Landsting","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004348","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003197","name":"Agenzia Italiana del Farmaco, Ministero della Salute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003197","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007723","name":"Takeda Pharmaceuticals U.S.A.","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007723","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100002039","name":"CURE Childhood Cancer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002039","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2016,8]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Based on data from the <jats:styled-content style=\"fixed-case\">EURAP<\/jats:styled-content> observational International registry of antiepileptic drugs (AEDs) and pregnancy, we assessed changes in seizure control and subsequent <jats:styled-content style=\"fixed-case\">AED<\/jats:styled-content> changes in women who underwent attempts to withdraw valproic acid (<jats:styled-content style=\"fixed-case\">VPA<\/jats:styled-content>) during the first trimester of pregnancy. Applying Bayesian statistics, we compared seizure control in pregnancies where <jats:styled-content style=\"fixed-case\">VPA<\/jats:styled-content> was withdrawn (withdrawal group, n = 93), switched to another <jats:styled-content style=\"fixed-case\">AED<\/jats:styled-content> (switch group, n = 38), or maintained (maintained\u2010therapy group, n = 1,588) during the first trimester. The probability of primarily or secondarily generalized tonic\u2013clonic seizures (<jats:styled-content style=\"fixed-case\">GTCS<\/jats:styled-content>) was lower in the maintained\u2010therapy group compared with the other two groups, both in the first trimester and for the entire duration of pregnancy. <jats:styled-content style=\"fixed-case\">GTCS<\/jats:styled-content> were twice as common during pregnancy in the withdrawal (33%) and switch groups (29%) compared with the maintained\u2010treatment group (16%). Limitations in the data and study design do not allow to establish a cause\u2013effect relationship between treatment changes and seizure outcome, but these observations provide a signal that withdrawal of, or switch from, <jats:styled-content style=\"fixed-case\">VPA<\/jats:styled-content> during the first trimester could lead to loss of seizure control, and highlight the need for a specifically designed prospective observational study.<\/jats:p>","DOI":"10.1111\/epi.13437","type":"journal-article","created":{"date-parts":[[2016,6,20]],"date-time":"2016-06-20T05:52:42Z","timestamp":1466401962000},"source":"Crossref","is-referenced-by-count":93,"title":["Withdrawal of valproic acid treatment during pregnancy and seizure outcome: Observations from <scp>EURAP<\/scp>"],"prefix":"10.1111","volume":"57","author":[{"given":"Torbj\u00f6rn","family":"Tomson","sequence":"first","affiliation":[{"name":"Department of Clinical Neuroscience Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dina","family":"Battino","sequence":"additional","affiliation":[{"name":"Epilepsy Center Department of Neurophysiology and Experimental Epileptology I.R.C.C.S. Neurological Institute \u201cCarlo Besta\u201d Foundation Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erminio","family":"Bonizzoni","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences and Community Laboratory of Medical Statistics Biometry and Epidemiology \u201cGA Maccacaro,\u201d University of Milan Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Craig","sequence":"additional","affiliation":[{"name":"Belfast Health and Social Care Trust Belfast Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9580-624X","authenticated-orcid":false,"given":"Dick","family":"Lindhout","sequence":"additional","affiliation":[{"name":"Department of Genetics University Medical Center Utrecht Utrecht The Netherlands"},{"name":"Epilepsy Institute in The Netherlands (SEIN) Heemstede The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilio","family":"Perucca","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Therapeutics University of Pavia Pavia Italy"},{"name":"Clinical Trial Center C. Mondino National Neurological Institute Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Sabers","sequence":"additional","affiliation":[{"name":"The Epilepsy Clinic Department of Neurology Rigshospitalet University State Hospital Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjeev V","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Neurology Sree Chitra Tirunal Institute of Medical Sciences and Technology Trivandrum Kerala State India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Vajda","sequence":"additional","affiliation":[{"name":"Departments of Medicine and Neurology University of Melbourne Royal Melbourne Hospital Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the EURAP Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,6,20]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(15)00314-2"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(12)70323-X"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000001182"},{"key":"e_1_2_8_5_1","first-page":"CD010236","article-title":"Treatment for epilepsy in pregnancy: neurodevelopmental outcomes in the child","volume":"10","author":"Bromley R","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.2270"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.13007"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.13021"},{"key":"e_1_2_8_9_1","unstructured":"European Medicines Agency.Assessment report. Procedure under Article 31 of Directive 2001\/83\/EC resulting from pharmacovigilance data. Available from:http:\/\/www.ema.europa.eu\/docs\/en_GB\/document_library\/Referrals_document\/Valproate_and_related_substances_31\/Recommendation_provided_by_Pharmacovigilance_Risk_Assessment_Committee\/WC500177352.pdf. Accessed on 10 April 2015."},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.12621"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2015.1017"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(11)70107-7"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.12302"},{"key":"e_1_2_8_14_1","unstructured":"O'HaganA.Bayesian statistics: Principles and benefits. Wageningen UR Frontis Series 3 31\u201045.2004. Available athttp:\/\/library.wur.nl\/frontis\/bayes\/03_o_hagan.pdf. Accessed March 12 2016."},{"key":"e_1_2_8_15_1","unstructured":"CookJD.Exact calculation of beta inequalities.2005. Technical Report UTMDABTR\u2010005\u201005. Available athttps:\/\/www.mdanderson.org\/education-and-research\/departments-programs-and-labs\/departments-and-divisions\/division-of-quantitative-sciences\/research\/biostats-utmdabtr-005-05.pdf. Accessed February 17 2016."}],"container-title":["Epilepsia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fepi.13437","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/epi.13437","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,17]],"date-time":"2023-09-17T13:02:14Z","timestamp":1694955734000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/epi.13437"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,6,20]]},"references-count":14,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2016,8]]}},"alternative-id":["10.1111\/epi.13437"],"URL":"https:\/\/doi.org\/10.1111\/epi.13437","archive":["Portico"],"relation":{},"ISSN":["0013-9580","1528-1167"],"issn-type":[{"value":"0013-9580","type":"print"},{"value":"1528-1167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,6,20]]}}}