Minerva
BMJ 2006; 332 doi: https://doi.org/10.1136/bmj.332.7552.1282 (Published 25 May 2006) Cite this as: BMJ 2006;332:1282All rapid responses
Rapid responses are electronic comments to the editor. They enable our users to debate issues raised in articles published on bmj.com. A rapid response is first posted online. If you need the URL (web address) of an individual response, simply click on the response headline and copy the URL from the browser window. A proportion of responses will, after editing, be published online and in the print journal as letters, which are indexed in PubMed. Rapid responses are not indexed in PubMed and they are not journal articles. The BMJ reserves the right to remove responses which are being wilfully misrepresented as published articles or when it is brought to our attention that a response spreads misinformation.
From March 2022, the word limit for rapid responses will be 600 words not including references and author details. We will no longer post responses that exceed this limit.
The word limit for letters selected from posted responses remains 300 words.
Dear Sirs,
I was intrigued and worried by Minerva's article stating 'Long term
use of antiepileptic drugs is associated with an increased use of cancers'
- BMJ 2006; 332: 1282. In our Epilepsy Unit, my colleagues and I are not
aware of such an association, which would clearly have significant
implications for patient management and counselling.
On acquiring the quoted article from Neurology 2006; 66: 1318-24, I
found the article which was titled 'Use of antiepileptic drugs and risk
of fractures'. Clinicians are already aware of this association (1). It
therefore seems that there has been a typo in Minerva's article.
I hope Minerva will issue a correction in a forthcoming issue of the
BMJ.
Yours sincerely,
Dr Linda Stephen
Deputy Director (services)
Epilepsy Unit
Western Infirmary
Glasgow
1. Stephen LJ, McLellan AR, Harrison JH et al. Bone density and
antiepileptic drugs. Seizure 1999; 8: 339-42
Competing interests:
None declared
Competing interests: No competing interests
I recently gave a lecture on adverse drug reactions and post
marketing surveilance.
One method is the case controlled study -this is usually retrospective
comparing a group of patients with particular disease with matched
controls.Surely your referring to a cohort study?
If on the other hand it is a case controlled sudy it appears as if the
outcome of interest was not pre -determined.
My stats is weak at the best of time please tell me this is an error?
Competing interests:
None declared
Competing interests: No competing interests
Minerva quoted a study stating that the risk of cancer in longer
terrm users of antiepileptics was markedly increased. Yet the link goes
to an abstract stating that the risk of fractures is increased with long
term anticonvulsant treatment.
Is the word cancer an error or is there a different study?
Competing interests:
None declared
Competing interests: No competing interests
This reply is probably more suited as an alert to a typographical
error, and is not really intended for publication online or otherwise.
The article in Minerva, referring to the paper by Souverein et al
(NEUROLOGY 2006;66:1318-1324)
(http://www.neurology.org/cgi/content/abstract/66/9/1318) incorrectly
states that the authors found "an increased risk of cancers" in those
taking anti-epileptic drugs.
The paper actually reports an increased risk of *fractures* in those
taking AEDs in the long-term, with a higher risk in women. I would guess
that for many people, an increased risk of fractures is perhaps a little
less alarming than an increased risk of cancers?
The apparent absence of copy-checking of this item might leave a
number of people unduly worried. Can it be corrected on the online version
before the Sunday papers pick up the item, as I'm pretty sure that they
won't read the original paper?
Regards,
David Christmas.
Competing interests:
None declared
Competing interests: No competing interests
Dear Sir,
We were intrigued to read in Minerva in this week’s BMJ that long
term use of antiepileptic drugs is associated with an increased risk of
cancers. We were, however, baffled on turning to the paper in question to
discover that the authors were studying the effect of anti-epileptic drugs
on fractures. The figures quoted by Minerva are accurate, but only if the
word ‘fractures’ is substituted for the word ‘cancers’.
This is a serious lapse, particularly as an investigation reported in
the current issue of the Journal of Neurology, Neurosurgery and Psychiatry
finds that ‘these results lend no support to the suggestion that epilepsy,
and presumably long term exposure to antiepileptic drugs, is associated
with an increase risk of the types of cancer included in the present
study.’(1) This finding, however, may not be the final word in the subject
and indeed, it is possible, that Minerva may eventually be proved right.
(2)
Josemir W. Sander, FRCP,
Gail S. Bell, MRCGP
Reference List
(1) Adelow C, Ahlbom A, Feychting M, Johnsson F, Schwartzbaum J,
Tomson T. Epilepsy as a risk factor for cancer. J Neurol Neurosurg
Psychiatry 2006; 77:784-786.
(2) Singh G, Driever PH, Sander JW. Cancer risk in people with
epilepsy: the role of antiepileptic drugs. Brain. 2005;128:7-17
Competing interests:
We are currently carrying out research in this specific area. Our department has received grant support from manufacturers of antiepileptic drugs. JWS has been consulted by and received research grants and fees for lectures from the manufacturers of most antiepileptic drugs. JWS is a council member of the British chapter of the International League against Epilepsy.
Competing interests: No competing interests
Anti-convulsants NOT linked to cancer.
Minerva's quote that anticonvulsants are linked to cancer by this
study is wrong. If you look at the original article, the risk of FRACTURES
is increased: the study was not about cancer
Competing interests:
I have also submitted this as an email to the editor
Competing interests: No competing interests