Abstract：
BACKGROUND: Sex differences in epilepsy have been described in prevalence, seizure propensity and response to treatment. Therefore, taking into account sex-based differences in epilepsy is important for both diagnostic purposes and therapeutic considerations. However, little is known about sex differences in adverse effects of antiseizure medications (ASMs).
OBJECTIVE: We performed a systematic review searching for sex differences in adverse effects of ASMs in adult persons with epilepsy (PWE) as part of a wider project aimed to assess sex-based differences in efficacy and adverse effects of ASMs in PWE.
METHODS: We conducted a comprehensive literature search in the PubMed database. The search was conducted with no restriction on publication date, and all results up to April 2020 were included. We included articles written in English, Italian, Spanish, or French that evaluated adverse effects of one or more ASMs in PWE, with specific mention of the two sexes. When appropriate, Newcastle-Ottawa or Jadad scales were used to assess study quality.
RESULTS: Of 5164 identified studies, only 167 considered sex in the analysis and were therefore included. Significant sex-related differences were found in 58 of those studies. We found a consistently higher frequency of cutaneous adverse effects in females; higher risk of developing general adverse effects on different ASMs in females; stronger risk of adverse effects on bone metabolism in females, mainly on treatment with enzyme-inducing ASMs; a concordant higher risk of visual field loss was noted in males on vigabatrin; an overall worse lipid profile in males; as well as higher leptin levels and higher body mass index in females treated with various ASMs.
CONCLUSIONS: Our analysis has identified some important sex differences in the adverse effects of ASMs. Clinicians should be aware of these differences when informing patients about the risks associated with ASM treatment in PWE.
OBJECTIVE: We performed a systematic review searching for sex differences in adverse effects of ASMs in adult persons with epilepsy (PWE) as part of a wider project aimed to assess sex-based differences in efficacy and adverse effects of ASMs in PWE.
METHODS: We conducted a comprehensive literature search in the PubMed database. The search was conducted with no restriction on publication date, and all results up to April 2020 were included. We included articles written in English, Italian, Spanish, or French that evaluated adverse effects of one or more ASMs in PWE, with specific mention of the two sexes. When appropriate, Newcastle-Ottawa or Jadad scales were used to assess study quality.
RESULTS: Of 5164 identified studies, only 167 considered sex in the analysis and were therefore included. Significant sex-related differences were found in 58 of those studies. We found a consistently higher frequency of cutaneous adverse effects in females; higher risk of developing general adverse effects on different ASMs in females; stronger risk of adverse effects on bone metabolism in females, mainly on treatment with enzyme-inducing ASMs; a concordant higher risk of visual field loss was noted in males on vigabatrin; an overall worse lipid profile in males; as well as higher leptin levels and higher body mass index in females treated with various ASMs.
CONCLUSIONS: Our analysis has identified some important sex differences in the adverse effects of ASMs. Clinicians should be aware of these differences when informing patients about the risks associated with ASM treatment in PWE.
摘要：
背景：癫痫的性别差异已被描述为患病率，癫痫发作倾向和对治疗的反应。因此,考虑癫痫的性别差异对诊断和治疗都很重要.然而,关于抗癫痫药物（ASM）不良反应的性别差异知之甚少。
目的：我们进行了系统评价，以寻找成人癫痫患者（PWE）中ASM不良反应的性别差异，作为旨在评估PWE中ASM疗效和不良反应性别差异的更广泛项目的一部分。
方法：我们在PubMed数据库中进行了全面的文献检索。进行搜寻时没有发表日期的限制,截至2020年4月的所有结果都包括在内。我们包括用英语写的文章，意大利语,西班牙语,或法语，评估PWE中一个或多个ASM的不利影响，特别提到了两种性别。在适当的时候,纽卡斯尔-渥太华或Jadad量表用于评估研究质量。
结果：在5164项确定的研究中，只有167人在分析中考虑了性别,因此被纳入.在其中58项研究中发现了与性别相关的显着差异。我们发现女性皮肤不良反应的频率一直较高;女性不同ASM发生一般不良反应的风险较高;女性骨骼代谢不良反应的风险更大。主要是用酶诱导的ASM治疗；在服用vigabatrin的男性中，视野丧失的风险明显较高；在服用各种ASM的男性中，血脂总体较差；在接受各种ASM治疗的女性中，瘦素水平较高，体重指数较高。
结论：我们的分析已经确定了ASM不良反应中的一些重要性别差异。在告知患者治疗时，临床医生应该
目的：我们进行了系统评价，以寻找成人癫痫患者（PWE）中ASM不良反应的性别差异，作为旨在评估PWE中ASM疗效和不良反应性别差异的更广泛项目的一部分。
方法：我们在PubMed数据库中进行了全面的文献检索。进行搜寻时没有发表日期的限制,截至2020年4月的所有结果都包括在内。我们包括用英语写的文章，意大利语,西班牙语,或法语，评估PWE中一个或多个ASM的不利影响，特别提到了两种性别。在适当的时候,纽卡斯尔-渥太华或Jadad量表用于评估研究质量。
结果：在5164项确定的研究中，只有167人在分析中考虑了性别,因此被纳入.在其中58项研究中发现了与性别相关的显着差异。我们发现女性皮肤不良反应的频率一直较高;女性不同ASM发生一般不良反应的风险较高;女性骨骼代谢不良反应的风险更大。主要是用酶诱导的ASM治疗；在服用vigabatrin的男性中，视野丧失的风险明显较高；在服用各种ASM的男性中，血脂总体较差；在接受各种ASM治疗的女性中，瘦素水平较高，体重指数较高。
结论：我们的分析已经确定了ASM不良反应中的一些重要性别差异。在告知患者治疗时，临床医生应该
