The Prevalence of Dupuytren’s Disease in Patients with Epilepsy

Authors, Author Information and Article Contact

Sandhya Ganesan, BS1, Kaitlyn N. Compitello, BS1, Benjamin N. Blond, MD2, David E. Komatsu, PhD1, Lawrence C. Hurst, MD1

1Department of Orthopaedics and Rehabilitation, Stony Brook University, Stony Brook, New York
2Department of Neurology, New York University, Grossman School of Medicine

 
Disclosure Statement
All authors declare that they have no conflicts of interest.
 
Citation
Ganesan S, Compitello KN, Blond BN, Komatsu DE, Hurst LCH: The Prevalence of Dupuytren’s Disease in Patients with Epilepsy. Stony Brook Journal of Scholarship, Innovation, and Quality Improvement - Orthopaedics 2023-2024, 18:
 
Keywords
Dupuytren’s disease, epilepsy, antiseizure medications
Abstract

Background: Dupuytren’s disease (DD) is a fibroproliferative disorder characterized by progressively worsening contractures of the fingers, first web, and thumb. This condition has been associated with various risk factors, one of which includes epilepsy and recurrent seizures. Antiseizure medications (ASMs) especially phenobarbital, have been implicated in the connection between the two conditions; however, their association remains unclear.

Purpose: This study evaluated data from a TriNetX network of 132,152,597 total patients, 1,492,227 patients with epilepsy, 141,237 patients with DD, and 4,244 patients with both epilepsy and DD, to assess the correlation between DD and epilepsy and factors that may influence this relationship.

Methods: This was a retrospective cohort study of patients with DD and epilepsy, including EMR data from patients included in the TriNetX Research Network. Cohorts of patients were
created using ICD-10 codes for DD and epilepsy, and sub-cohorts of patients with epilepsy were created based on the ASMs prescribed to them. Risk ratios were used to determine the
association of ASMs with DD.

Results: A significantly higher prevalence of DD was found among patients with epilepsy compared to the overall population. Specifically, patients taking first-generation ASMs carried a significantly higher risk than those taking second- and third-generation ASMs. When compared by drug class, patients taking barbiturates carried the highest risk for DD, whereas patients taking pyrrolidines carried the lowest risk for DD. Patients with epilepsy who did not take any ASMs had the lowest risk of DD.

Conclusions: The significantly higher prevalence of DD among patients with epilepsy may be due to shared inflammatory pathways. The varied risk of DD depending on the generation or class of ASMs might reflect differing effects on cytokine pathways by different drugs. The results of the present study can help clinicians identify patients who are at higher risk of DD, and future studies characterizing signaling pathways affected by ASMs may help further specify the relationship between these two conditions.

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