Inducers and Cardiovascular Risk—Potential Role for Lowered Drug Exposure—Reply

Josephson et al respond to comments from Van der Linden and colleagues regarding their article Inducers and Cardiovascular Risk-Potential Role for Lowered Drug Exposure. The article described the long-term cardiovascular risk associated with continued use of enzyme-inducing antiseizure medications (eiASMs). They state that with respect to their mediation analysis, they considered incident dyslipidemia as a binary mediator variable, as opposed to a continuous variable of low-density lipoprotein cholesterol or total cholesterol, given its direct clinical relevance as the threshold over which treatment is initiated. However, they agree that future efforts at exploring a dose-dependent mediation between absolute and relative increases in low-density lipoprotein cholesterol and total cholesterol compared with baseline (pre-eiASM) treatment levels is warranted to further elucidate this potential mechanism.