Exposure of Infants Who Are Breastfed to Antiepileptic Drugs-Reply

Angela K. Birnbaum, Kimford J. Meador, Page B. Pennell

Research output: Contribution to journalLetterpeer-review

Original languageEnglish (US)
Pages (from-to)1577-1578
Number of pages2
JournalJAMA Neurology
Issue number12
Early online dateJul 24 2020
StatePublished - Dec 2020

Bibliographical note

Funding Information:
Conflict of Interest Disclosures: Dr Pittock reported receiving grants, personal fees, and nonfinancial support from Alexion Pharmaceuticals; grants from Grifols and the Autoimmune Encephalitis Alliance; grants, personal fees, nonfinancial support, and other from MedImmune; other support from Astellas; and personal fees from UCB; and having Patent No. 8,889,102 (Application No. 12-678350)—Neuromyelitis Optica Autoantibodies as a Marker for Neoplasia— issued; and Patent No. 9,891,219B2 (Application No. 12-573942)—Methods for Treating Neuromyelitis Optica (NMO) by Administration of Eculizumab to an Individual That Is Aquaporin-4 (AQP4)-IgG Autoantibody Positive—issued. Dr Lucchinetti reported receiving grants from Biogen, National Multiple Sclerosis Society, Kingsland Foundation, and National Institute of Neurological Disorders and Stroke during the conduct of the study. Dr Flanagan reported serving as a site principal investigator for a clinical trial of inebilizumab in neuromyelitis optica spectrum disorder and receiving funding to support the research work from Viela Bio during the conduct of the study. No other disclosures were reported. Funding/Support: This work was supported by funding from the National Institutes of Health (R01NS113828).

Funding Information:
study was from the National Institute of Neurological Disorders and Stroke and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (grants U01-NS038455 [Drs Meador and Pennell] and U01-NS050659 [May]). Dr Meador reported grants from Sunovion Pharm, personal fees from Epilepsy Study Consortium (which pays Dr Meador’s university for his research consultant time for Eisai, GW Pharmaceuticals, NeuroPace, Novartis, Supernus, Upsher-Smith Laboratories, UCB Pharma, and Vivus Pharmaceuticals), and travel support from UCB Pharma outside the submitted work. Dr Pennell reported grants from the National Institutes of Health during the conduct of the study. Published Online: August 24, 2020. doi:10.1001/jamaneurol.2020.3033 1. Birnbaum AK, Meador KJ, Karanam A, et al; MONEAD Investigator Group. Antiepileptic drug exposure in infants of breastfeeding mothers with epilepsy. JAMA Neurol. 2020;77(4):441-450. doi:10.1001/jamaneurol.2019.4443 2. Vaithianathan S, Raman S, Jiang W, Ting TY, Kane MA, Polli JE. Biopharmaceutic risk assessment of brand and generic lamotrigine tablets. Mol Pharm. 2015;12(7):2436-2443. doi:10.1021/acs.molpharmaceut.5b00154 3. GlaxoSmithKline. Lamictal (lamotrigine) tablets; lamictal (lamotrigine) chewable dispersible tablets. Published 2005. Accessed July 17, 2020. https:// www.accessdata.fda.gov/drugsatfda_docs/label/2006/020241 s10s21s25s26s27,020764s3s14s18s19s20lbl.pdf 4. Baldoni AO, Freitas-Lima P, de Santi Ferreira FI, et al. An investigation of the influence of patient-related factors and comedications on lamotrigine clearance in patients with epilepsy. Clin Exp Pharmacol Physiol. 2016;43(7):685-689. doi: 10.1111/1440-1681.12584 5. Alcorn J, McNamara PJ. Ontogeny of hepatic and renal systemic clearance pathways in infants: part I. Clin Pharmacokinet. 2002;41(12):959-998. doi:10.2165/00003088-200241120-00003 6. Alcorn J, McNamara PJ. Ontogeny of hepatic and renal systemic clearance pathways in infants: part II. Clin Pharmacokinet. 2002;41(13):1077-1094. doi:10.2165/00003088-200241130-00005

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