Austin Health

Title
Proposal for reference values for the developmental effects of valproate based on human data using a benchmark dose approach.
Publication Date
2023-03
Author(s)
Manière-Guerrero, Isabelle
Bonizzoni, Erminio
Battino, Dina
Clinard, François
Mathieu-Huart, Aurélie
Perucca, Emilio
Pouzaud, François
Tomson, Torbjorn
Thomas, Sanjeev V
Vajda, Frank
Rousselle, Christophe
Subject
Benchmark dose
Children
Congenital malformation
Modeling
Neurodevelopment
Pregnant women
Toxicological reference value
Valproate
Type of document
Journal Article
OrcId
#PLACEHOLDER_PARENT_METADATA_VALUE#
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DOI
10.1016/j.yrtph.2023.105367
Abstract
Following accidental release of valproate into ambient air during manufacture at a French production site in 2018, concerns were raised for inhabitants of the surrounding area. As no toxicological reference value (TRV) was available, the risks could not be properly assessed. The French Agency for Food, Environmental and Occupational Health and Safety (ANSES) was mandated to determine a TRV by inhalation to be used for risk assessment. Major congenital malformations (MCMs) in offsprings of mothers exposed to valproate during pregnancy have been reported in international scientific literature. As these adverse effects were the most sensitive effect identified, they were retained as the critical effect to be used for the TRV. The data from a robust registry on MCMs established by the International Registry of Antiepileptic Drugs and Pregnancy (EURAP) were modellized and support a strong DRR between the prevalence of MCMs in the fetus and in utero exposure. A benchmark dose (BMD) was then calculated as the dose that may trigger a 5% increase in this risk. A lower 95% confidence limit (BMD5%L95%) of 2.26 mg/kg/day, leading to an oral TRV of 0.08 mg/kg/day and a respiratory TRV of 0.26 mg.m-3 after applying an uncertainty factor of 30, was determined.
Link
Citation
Regulatory toxicology and pharmacology : RTP 2023; 139: 105367
Jornal Title
Regulatory toxicology and pharmacology : RTP
ISSN
1096-0295

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