P.5.d.001 Impact of valproate-related adverse events on quality of life in pediatric epilepsy

Abstract

Purpose: The cornerstone of successful epilepsy treatment is the use of antiepileptic drugs (AEDs). However, AEDs could have significant negative effects predominantly on higher cognitive functions, emotions, and motor functions [1,2]. Well-being, functional status, and quality of life (QOL) are significantly affected across various domains among children and adolescents with epilepsy [3]. Among various socio-demographic and epilepsy variables, AEDs are suspected to significantly affect everyday functioning, but limited evidence is found to support the impact of AEDs side effects. The present study evaluated how present valproate adverse events relate to levels of functioning and QOL among children with epilepsy. Methods: Data from 54 children with active epilepsy treated only with valproate [32 (54.2%) males, age mean = 12.3 (2.7) years] and from at least one of their parents was available for the present study. The Pediatric Quality of Life Inventory (PedsQL) was used to assess levels of general physical, social, and school functioning and the Health-Related Quality of Life Measure for Children with Epilepsy (CHEQOL-25) was used to assess epilepsy-related QOL. The both questionnaires were completed by children and parents. The Adverse Event Profile (AEP) in an interview-based method was used to assess the presence and severity of adverse events of valproate. Regression analysis was used for data modeling with socio-demographic and epilepsy variables significantly correlating with the PedsQL and CHEQOL25 scores as covariates. Results: Four (7.4%) children did not report any of adverse events studied; ten (18.5%) children had some adverse events occasionally during the past three months; five (9.3%) children had constant problems with memory since valproate-treatment was initiated. For the children’s ratings, the AEP score emerged as a significant predictor of the CHEQOL-25 domains evaluating emotional well-being and worries/concerns about epilepsy (p 0.01; partial h2 equals 0.16 and 0.15, respectively) and of the PedsQL domains evaluating physical and school functioning (p 0.015; partial h2 equals 0.20 and 0.12, respectively). On the other hand, for the parents’ ratings, the AEP score emerged as a significant predictor of the CHEQOL-25 domains evaluating emotional well-being and future worries/concerns about epilepsy (p 0.04; partial h2 equals 0.10 and 0.14, respectively) and of the PedsQL domains evaluating social and school functioning (p 0.02; partial h2 equals 0.12, and 0.23 respectively). Conclusions: The frequency and severity of present valproaterelated adverse events was significantly related to lower levels of everyday functioning and epilepsy related QOL among children with epilepsy in the present study. Considering reports from children and parents, the largest possible impact of valproate-related adverse events was observed on physical and school functioning. With more data available from follow-up studies, it would be possible to develop specific interventions for reducing the burdens of AEDs by targeting particular domains.