BACKGROUND: Additional medications are needed for inflammatory bowel disease (IBD) as existing therapies are incompletely effective and can be costly and toxic. Preclinical studies suggest that topiramate (an anticonvulsant) may have disease-modifying properties in IBD, but its efficacy in humans is unknown. AIM: To evaluate whether topiramate use is associated with clinical benefit in IBD patients. METHODS: We conducted a retrospective cohort study using administrative claims data from the MarketScan databases. Persons with IBD were identified between 2000 and 2010. New users of topiramate were compared with users of other anticonvulsant and anti-migraine medications. The primary outcome was a new prescription for an oral steroid (≥14 days). Secondary outcomes included initiation of biologic agents, abdominal surgery, and hospitalization. Cox proportional hazard modeling was used to adjust for potential confounders. RESULTS: We identified 773 new users of topiramate and 958 users of comparator drugs. After adjusting for potential confounders, topiramate use was not associated with the primary outcome of steroid prescriptions [hazard ratio (HR) 1.14, 95 % confidence interval (CI) 0.74, 1.73]. Results did not differ significantly by IBD subtype. There was no difference between topiramate users and users of comparator drugs with respect to post-exposure initiation of biologic agents (HR 0.93, 95 % CI 0.39, 2.19), abdominal surgery (HR 1.04, 95 % CI 0.17, 6.41), or hospitalization (HR 0.86, 95 % CI 0.62, 1.19). CONCLUSION: In this large U.S. administrative claims study, topiramate use was not associated with markers of IBD flares. These results cast doubt on whether topiramate may be an effective adjunct to current IBD therapy.
BACKGROUND: Additional medications are needed for inflammatory bowel disease (IBD) as existing therapies are incompletely effective and can be costly and toxic. Preclinical studies suggest that topiramate (an anticonvulsant) may have disease-modifying properties in IBD, but its efficacy in humans is unknown. AIM: To evaluate whether topiramate use is associated with clinical benefit in IBD patients. METHODS: We conducted a retrospective cohort study using administrative claims data from the MarketScan databases. Persons with IBD were identified between 2000 and 2010. New users of topiramate were compared with users of other anticonvulsant and anti-migraine medications. The primary outcome was a new prescription for an oral steroid (≥14 days). Secondary outcomes included initiation of biologic agents, abdominal surgery, and hospitalization. Cox proportional hazard modeling was used to adjust for potential confounders. RESULTS: We identified 773 new users of topiramate and 958 users of comparator drugs. After adjusting for potential confounders, topiramate use was not associated with the primary outcome of steroid prescriptions [hazard ratio (HR) 1.14, 95 % confidence interval (CI) 0.74, 1.73]. Results did not differ significantly by IBD subtype. There was no difference between topiramate users and users of comparator drugs with respect to post-exposure initiation of biologic agents (HR 0.93, 95 % CI 0.39, 2.19), abdominal surgery (HR 1.04, 95 % CI 0.17, 6.41), or hospitalization (HR 0.86, 95 % CI 0.62, 1.19). CONCLUSION: In this large U.S. administrative claims study, topiramate use was not associated with markers of IBD flares. These results cast doubt on whether topiramate may be an effective adjunct to current IBD therapy.
Authors: James D Lewis; Faten N Aberra; Gary R Lichtenstein; Warren B Bilker; Colleen Brensinger; Brian L Strom Journal: Gastroenterology Date: 2004-03 Impact factor: 22.682
Authors: Michael J Goodman; Michael Durkin; Jamie Forlenza; Xiangyang Ye; Diana I Brixner Journal: Int J Qual Health Care Date: 2012-04-16 Impact factor: 2.038
Authors: S Singhal; J Mehta; R Desikan; D Ayers; P Roberson; P Eddlemon; N Munshi; E Anaissie; C Wilson; M Dhodapkar; J Zeddis; B Barlogie Journal: N Engl J Med Date: 1999-11-18 Impact factor: 91.245
Authors: Mohamed Noureldin; Peter D R Higgins; Shail M Govani; Shirley Cohen-Mekelburg; Brooke C Kenney; Ryan W Stidham; Jennifer F Waljee; Akbar K Waljee Journal: Aliment Pharmacol Ther Date: 2018-11-14 Impact factor: 8.171
Authors: Stephan C Bischoff; Rocco Barazzoni; Luca Busetto; Marjo Campmans-Kuijpers; Vincenzo Cardinale; Irit Chermesh; Ahad Eshraghian; Haluk Tarik Kani; Wafaa Khannoussi; Laurence Lacaze; Miguel Léon-Sanz; Juan M Mendive; Michael W Müller; Johann Ockenga; Frank Tacke; Anders Thorell; Darija Vranesic Bender; Arved Weimann; Cristina Cuerda Journal: United European Gastroenterol J Date: 2022-08-12 Impact factor: 6.866
Authors: Sudeep Pushpakom; Francesco Iorio; Patrick A Eyers; K Jane Escott; Shirley Hopper; Andrew Wells; Andrew Doig; Tim Guilliams; Joanna Latimer; Christine McNamee; Alan Norris; Philippe Sanseau; David Cavalla; Munir Pirmohamed Journal: Nat Rev Drug Discov Date: 2018-10-12 Impact factor: 84.694
Authors: Patrick Wu; QiPing Feng; Vern Eric Kerchberger; Scott D Nelson; Qingxia Chen; Bingshan Li; Todd L Edwards; Nancy J Cox; Elizabeth J Phillips; C Michael Stein; Dan M Roden; Joshua C Denny; Wei-Qi Wei Journal: Nat Commun Date: 2022-01-10 Impact factor: 17.694
Authors: Jeffrey A Berinstein; Shirley A Cohen-Mekelburg; Calen A Steiner; Megan McLeod; Mohamed Noureldin; John I Allen; Jeffrey T Kullgren; Akbar K Waljee; Peter D R Higgins Journal: Inflamm Bowel Dis Date: 2021-05-17 Impact factor: 7.290
Authors: Lawrence Bai; Madeleine K D Scott; Ethan Steinberg; Laurynas Kalesinskas; Aida Habtezion; Nigam H Shah; Purvesh Khatri Journal: J Am Med Inform Assoc Date: 2021-10-12 Impact factor: 4.497