Efek Samping Polifarmasi Asam Valproat dan Topiramat Dibandingkan Monofarmasi Asam Valproat pada Pasien Epilepsi
Sari
Latar belakang. Dua pertiga kasus epilepsi membaik dengan OAE dan keberhasilan bebas kejangnya dengan monofarmasi dicapai pada 55% kasus. Sedangkan sisanya mendapatkan polifarmasi. Pemberian polifarmasi meningkatkan angka bebas kejang tetapi juga dapat meningkatkan kejadian efek samping obat.
Tujuan. Untuk melihat efek samping polifarmasi asam valproat dan topiramat dibandingkan monofarmasi asam valproat pasien epilepsi anak di RS Dr. Kariadi Semarang.
Metode. Desain kohort prospektif pasien epilepsi di poli anak RSUP dr. Kariadi Semarang periode 2018 hingga 2020. Subyek yang memenuhi kriteria inklusi diambil secara consecutive sampling. Trombositopenia dan peningkatan kadar enzim transaminase merupakan variabel yang diteliti. Hubungan antara polifarmasi dan risiko efek samping dilihat melalui risiko relatif (RR). Nilai p bermakna apabila p<0,05.
Hasil. Didapatkan 23 anak mendapatkan polifarmasi dan 23 anak mendapatkan monofarmasi. Analisis menunjukkan terdapat peningkatan kejadian trombositopenia pada anak yang mendapatkan polifarmasi dibandingkan monofarmasi pada 6 bulan pertama terapi epilepsi (p=0,044). Anak yang mendapatkan polifarmasi memiliki kejadian peningkatan kadar enzim SGOT lebih tinggi (OR 4,4; IK 95% 1,2-15,4; p= 0,017) dan SGPT lebih tinggi (OR 9,6; IK 95% 1,1-86,2; p= 0,047) dibandingkan monofarmasi pada 6 bulan pertama terapi epilepsi.
Kesimpulan. Terdapat peningkatan kejadian trombositopenia dan peningkatan kadar enzim transaminase pada anak yang mendapatkan polifarmasi asam valproat dan topiramat dibandingkan monofarmasi asam valproat pada 6 bulan pertama terapi epilepsi.
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DOI: http://dx.doi.org/10.14238/sp23.4.2021.247-54
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