Bone Mineral Density in Ambulatory Epileptic Children with New Antiepileptic Drug Monotherapy
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Purpose:This study was conducted for evaluation of the effects of new antiepileptic drugs on bone mineral density in children with epilepsy. Methods:The study group consisted of 35 age and gender matched controls and 35 epileptic children taking new antiepileptic drugs: 14 on topiramate, 10 on lamotrigine, and 11 on oxcarbazepine in monotherapy. All patients were treated for more than one year and all were normally ambulatory children. We measured serum levels of calcium, alkaline phosphatase, 25-hydroxyvitamin D, and 1,25-dihydroxyvitamin D. BMD was measured by dual-energy X-ray absorptiometry at lumbar spine regions L1-L4. Results:Vitamin D levels of the oxcarbazepine group (25-hydroxyvitamin D: 40.3±10.5 ng/mL and 1,25-dihydroxyvitamin D: 57.9±15.2 pg/mL) were significantly lower than in controls (44.6±11.5 ng/mL, 66.2±10.5 pg/mL, P<0.05); however, they did not differ significantly in the topiramate and lamotrigine groups. The bone mineral density value was significantly lower in the oxcarbazepine (L1-L4: 0.73± 0.11 g/cm2) group, compared with the controls (0.84±0.06 g/cm2, P<0.05) or patients taking topiramate or lamotrigine. Conclusion:Monitoring of bone metabolism is recommended for patients treated with new antiepileptic drugs, particularly oxcarbazepine.
Abstract
Purpose:This study was conducted for evaluation of the effects of new antiepileptic drugs on bone mineral density in children with epilepsy. Methods:The study group consisted of 35 age and gender matched controls and 35 epileptic children taking new antiepileptic drugs: 14 on topiramate, 10 on lamotrigine, and 11 on oxcarbazepine in monotherapy. All patients were treated for more than one year and all were normally ambulatory children. We measured serum levels of calcium, alkaline phosphatase, 25-hydroxyvitamin D, and 1,25-dihydroxyvitamin D. BMD was measured by dual-energy X-ray absorptiometry at lumbar spine regions L1-L4. Results:Vitamin D levels of the oxcarbazepine group (25-hydroxyvitamin D: 40.3±10.5 ng/mL and 1,25-dihydroxyvitamin D: 57.9±15.2 pg/mL) were significantly lower than in controls (44.6±11.5 ng/mL, 66.2±10.5 pg/mL, P<0.05); however, they did not differ significantly in the topiramate and lamotrigine groups. The bone mineral density value was significantly lower in the oxcarbazepine (L1-L4: 0.73± 0.11 g/cm2) group, compared with the controls (0.84±0.06 g/cm2, P<0.05) or patients taking topiramate or lamotrigine. Conclusion:Monitoring of bone metabolism is recommended for patients treated with new antiepileptic drugs, particularly oxcarbazepine.
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