{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T18:24:22Z","timestamp":1793384662770,"version":"4.5.0"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,12,1]],"date-time":"2024-12-01T00:00:00Z","timestamp":1733011200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T00:00:00Z","timestamp":1733443200000},"content-version":"vor","delay-in-days":5,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Acta Epileptologica"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Liver damage, coagulopathy, hyperammonemia, fracture, menstrual disorder and amenorrhea are the most concerned adverse drug reactions of valproic acid\u00a0(VPA). This study was aimed to retrospectively investigate the incidence of adverse drug reactions of VPA in the real world and its association with the age of patients and duration of treatment in order to obtain the safety data of VPA in children with epilepsy.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A total of 1943 patients diagnosed as epilepsy by the Pediatric Neurology Department of Shenzhen Children\u2019s Hospital between December 2013 and December 2023, were included in the study. They received VPA as an initial treatment, and had followed up examinations over a time span of at least two years focusing on the adverse drug reactions of VPA.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>There was no significant difference in the incidence of liver damage, coagulation test abnormalities, and nasal bleeding during VPA monotherapy (30\u201390\u00a0days, 90\u2013180\u00a0days, and\u00a0&gt; 2\u00a0years). Adolescent female patients (first visit age \u2265 12 years)\u00a0showed no significant difference in the incidence of adverse reactions and abnormal ultrasound of the reproductive system pre- versus post-treatment\u00a0at the first visit, similar for those below\u00a012 years. However,\u00a0laboratory blood tests revealed significantly\u00a0age-dependent changes\u00a0in certain\u00a0biochemical markers. Two patients stopped VPA treatment due to thrombocytopenia and ovarian cystic mass comorbid with endometrial hyperplasia,\u00a0recovering after VPA withdrawal. <\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The initial monotherapy of VPA is generally safe in children with epilepsy of all age ranges. In the real world, VPA does not increase the risk of liver damage, coagulation disorder, elevated blood ammonia, fractures, or low serum sodium, but may significantly decrease the platelet count at 3, 6, 12, and 24\u00a0months of treatment. There is no evidence showing that VPA may increase the incidence of impairment of adolescent female reproductive system. Among children under 1\u00a0year old, it is recommended to monitor the levels of serum ammonia and aspartate aminotransferase carefully.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Trial registration<\/jats:title>\n                <jats:p>ChiCTR2300075115.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s42494-024-00188-x","type":"journal-article","created":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T00:01:16Z","timestamp":1733443276000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The safety of valproic acid treatment in children with epilepsy: a retrospective real-world research"],"prefix":"10.1186","volume":"6","author":[{"given":"Xiner","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yujie","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruoyu","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dezhi","family":"Cao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bing","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tieshuan","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jialun","family":"Wen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9769-3365","authenticated-orcid":false,"given":"Jianxiang","family":"Liao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,12,6]]},"reference":[{"issue":"2","key":"188_CR1","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1684\/epd.2015.0736","volume":"17","author":"P Camfield","year":"2015","unstructured":"Camfield P, Camfield C. Incidence, prevalence and aetiology of seizures and epilepsy in children. Epileptic Disord. 2015;17(2):117\u201323.","journal-title":"Epileptic Disord"},{"issue":"2","key":"188_CR2","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1159\/000503831","volume":"54","author":"E Beghi","year":"2020","unstructured":"Beghi E. The epidemiology of epilepsy. Neuroepidemiology. 2020;54(2):185\u201391.","journal-title":"Neuroepidemiology"},{"issue":"10282","key":"188_CR3","doi-asserted-by":"publisher","first-page":"1375","DOI":"10.1016\/S0140-6736(21)00246-4","volume":"397","author":"A Marson","year":"2021","unstructured":"Marson A, Burnside G, Appleton R, Smith D, Leach JP, Sills G, et al. SANAD II collaborators.The SANAD II study of the effectiveness and cost-effectiveness of valproate versus levetiracetam for newly diagnosed generalised and unclassifiable epilepsy: an open-label, non-inferiority, multicentre, phase 4, randomised controlled trial. 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Chinese Journal of Hospital Pharmacy. 2011;31(3):256\u20138 (In Chinese).","journal-title":"Chinese Journal of Hospital Pharmacy"}],"container-title":["Acta Epileptologica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s42494-024-00188-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s42494-024-00188-x\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s42494-024-00188-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T01:02:47Z","timestamp":1733446967000},"score":1,"resource":{"primary":{"URL":"https:\/\/aepi.biomedcentral.com\/articles\/10.1186\/s42494-024-00188-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12]]},"references-count":24,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,12]]}},"alternative-id":["188"],"URL":"https:\/\/doi.org\/10.1186\/s42494-024-00188-x","relation":{},"ISSN":["2096-9384","2524-4434"],"issn-type":[{"value":"2096-9384","type":"print"},{"value":"2524-4434","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12]]},"assertion":[{"value":"21 April 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 September 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 December 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Medical Ethics Committee of Shenzhen Children\u2019s Hospital\u00a0(No.\u00a02023061). This study was exempted from obtaining participant consent according to the Medical Ethics Committee of Shenzhen Children\u2019s Hospital.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"All authors declare no competing interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"39"}}