Effects of levetiracetam and valproic acid treatment on liver function tests, plasma free carnitine and lipid peroxidation in childhood epilepsies

Haznedar, Pınar; Doğan, Özlem; Albayrak, Pelin; Tunçer, Gökçen Öz; Teber, Serap; Deda, Gülhıs; Eminoğlu, Fatma Tuba

doi:10.1016/j.eplepsyres.2019.03.009

Cited by 21 publications

(15 citation statements)

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“…This is consistent with reports by Haznedar and colleagues who did not observe any evidence of hepatotoxicity in a cohort of patients with epilepsy on treatment with therapeutic doses of VPA. 23 The study also did not show any significant elevation in AST levels in children with epilepsy on other AEDs, CBZ and levetiracetam. This observation is at variance with the report by Haznedar and colleagues.…”

Section: Discussionmentioning

confidence: 61%

Non-Dose-Dependent Changes in Liver Enzyme Levels of Children With Epilepsy on Treatment With Sodium Valproate

2020

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Background: Sodium valproate (VPA) is considered as the drug of choice for the treatment of generalized epilepsy in children. Sodium Valproate may be hepatotoxic. Aim: To assess the level of derangement of liver enzymes in children with epilepsy on treatment with sodium valproate. Methods: A cohort study. One hundred fifty-three children, comprising 51 with epilepsy on treatment with VPA (group I), 51 with epilepsy on treatment with other antiepileptic drugs (AEDs) but not VPA (group II), and 51 with nonconvulsive disorders (group III) had liver function tests performed for them. Data were analyzed by SPSS version 23.0. Results: There were 85 males and 68 females, aged 6 months to 14 years (median = 7.0 years). There was no significant difference in the mean plasma levels of alanine transaminase (ALT), alkaline phosphatase, and gamma glutamyl transferase across the three groups of children. The mean aspartate transaminase level was significantly higher in children in group III. There was a statistically significant negative correlation between the duration of AED therapy and the mean serum level of AST ( r = −0.266, P = 0.016). The serum ALT level showed a statistically significant positive correlation with the duration of AED therapy ( r = 0.268, P = 0.015). Conclusion: Sodium valproate monotherapy does not appear to be associated with significant hepatotoxicity in children in our cohort.

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Section: Discussionmentioning

confidence: 61%

Non-Dose-Dependent Changes in Liver Enzyme Levels of Children With Epilepsy on Treatment With Sodium Valproate

2020

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“…Bolagir E et al reported that AEDs such as oxacarbamazepine as a new-AED have antioxidant effects 28 . Another study showed that epileptic children under therapeutic doses of levetiracetam had significantly increased levels of MDA and 8-OHdG, which is defensive for oxidative damage 29 . Baysal M et al also showed that SOD activity was increased in male patients after LEV therapy compared to placebo.…”

Section: Discussionmentioning

confidence: 99%

Effect of levetiracetam drug on antioxidant and liver enzymes in epileptic patients: case-control study

Mahdavi¹,

Naeini²,

Najafi³

et al. 2020

Afr H. Sci.

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Background: There is a limited amount of data regarding levetiracetam (LEV), an antiepileptic drug. Objective: This study was conducted to assess the effect of LEV on antioxidant status and liver enzymes. Method: In this case-control study, 33 epileptic patients under treatment with LEV for at least 6 months were compared with 35 healthy subjects. We measured serum total antioxidant capacity (TAC), salivary superoxide dismutase (SOD), alanine aminoteransferase (ALT), and aspartate aminoteransferase (AST) levels in both groups. Dietary intakes were collected using a Food Frequency Questionnaire (FFQ). Result: The level of TAC in the healthy subjects was significantly higher than it was in the patients (P=0.02), but the mean of ALT (P=0.02) and AST (P=0.03) was significantly higher in the patients in comparison with the controls. Mean salivary SOD showed no difference between the two groups. In the patients, the duration of drug use was inversely correlated with serum TAC (p=0.04) and had a direct correlation with ALT (p=0.01) and AST (p=0.03.). Conclusion: The results of our study indicated that LEV increased liver enzymes Also, treatment with this drug did not improve oxidative stress, but this could be due to the different in the dietary antioxidant intake. Routine screening of the liver and antioxidant enzymes in patients with chronic use of LEV is recommended. Keywords: Levetiracetam; antioxidant; liver enzymes; epilepsy.

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“…Investigations by Schulpis et al [8] and Li et al [9] found that VPA treatment caused the significant elevation of serum liver enzymes including alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma glutamyltransferase (GGT) in patients with epilepsy. In contrast, studies from Haznedar et al [10] and Luef et al [11] suggested that VPA treatment was not associated with increased serum liver enzyme levels. However, it is difficult and inadequate to make definite and comprehensive conclusions from a single study.…”

Section: Introductionmentioning

confidence: 88%

Effects of Sodium Valproate Monotherapy on Blood Liver Enzyme Levels in Patients with Epilepsy: A Meta-Analysis

Tao

et al. 2021

Horm Metab Res

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We conducted this meta-analysis to assess the effects of sodium valproate (VPA) monotherapy on blood liver enzymes in patients with epilepsy. PubMed, Web of Science, EBSCO, Cochrane Library, Wanfang, China national knowledge infrastructure databases were searched. Nine studies were included. Results showed: (1) The overall SMD for blood AST, ALT, and GGT levels of VPA monotherapy group versus control group were 0.70 (95% CI=0.31 to 1.09, Z=3.52, p=0.0004), 0.47 (95% CI=− 0.01 to 0.95, Z=1.91, p=0.06), 0.44 (95% CI=0.29 to 0.60, Z=5.55, p<0.00001), respectively. (2) In subgroup meta-analysis, increased blood AST and GGT levels were observed in epileptic minors (AST: total SMD=0.85, 95% CI=0.40 to 1.30, Z=3.69, p=0.0002; GGT: total SMD=0.46, 95% CI=0.29 to 0.63, Z=5.25, p<0.00001). Elevated blood ALT level was observed in Asian patients receiving VPA monotherapy (total SMD=0.70, 95% CI=0.51 to 0.90, Z=7.01, p<0.00001), and the early stage of VPA monotherapy (total SMD=0.93, 95% CI=0.57 to 1.29, Z=5.09, p<0.00001). Overall, our results indicated that blood AST and GGT were significantly increased in epileptic minors receiving VPA monotherapy. The elevation of blood ALT was observed in Asian patients and the early stage of VPA monotherapy. However, due to the small number of included studies, our results should be considered with caution.

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Effects of levetiracetam and valproic acid treatment on liver function tests, plasma free carnitine and lipid peroxidation in childhood epilepsies

Cited by 21 publications

References 46 publications

Non-Dose-Dependent Changes in Liver Enzyme Levels of Children With Epilepsy on Treatment With Sodium Valproate

Non-Dose-Dependent Changes in Liver Enzyme Levels of Children With Epilepsy on Treatment With Sodium Valproate

Effect of levetiracetam drug on antioxidant and liver enzymes in epileptic patients: case-control study

Effects of Sodium Valproate Monotherapy on Blood Liver Enzyme Levels in Patients with Epilepsy: A Meta-Analysis

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