Is the prevalence of thyroid disease higher in children receiving antiepileptic medication? A systematic review and meta-analysis

Ilia, Tatiani Soultana M.; Dragoumi, Pinelopi; Papanikolopoulou, Stavroula; Goulis, Dimitrios G.; Pavlou, Evangelos; Zafeiriou, Dimitrios

doi:10.1016/j.seizure.2021.11.010

Cited by 5 publications

(3 citation statements)

References 49 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The CBD oral solution was safe and very well tolerated in our patients after one year of follow-up. Compared to previous reports, somnolence and decreased appetite were expected, as these are one of the most frequent CBD-associated adverse events reported in pediatric and adult patients [25][26][27]38,[44][45][46]. The low incidence of adverse drug reactions may be explained by the lower median dose compared to other studies and because it was a study cohort under long-term CBD treatment, since the onset of most adverse events is more probable during the first month of treatment.…”

Section: Discussionmentioning

confidence: 73%

“…Both findings in the present study and our previous report are the only evidence of the influence of levothyroxine on CBD exposure. Most probably, we have been able to determine this relationship due to the high proportion of epileptic patients treated for hypothyroidism in our hospital with traditional anticonvulsants such as valproic acid and carbamazepine with precedents of thyroid hormone metabolic disturbances [ 44 , 45 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Real-World Evidence of Factors Affecting Cannabidiol Exposure in Children with Drug-Resistant Developmental and Epileptic Encephalopathies

Brstilo,

Reyes Valenzuela,

Caraballo

et al. 2023

Pharmaceutics

View full text Add to dashboard Cite

The identification of factors that affect cannabidiol (CBD) systemic exposure may aid in optimizing treatment efficacy and safety in clinical practice. In this study, we aimed to correlate CBD plasma concentrations at a steady state to demographic, clinical, and pharmacological characteristics as well as seizure frequency after the administration of a purified CBD oil solution in a real-world setting of children with drug-resistant developmental and epileptic encephalopathies (DEEs). Patients receiving oral CBD pharmaceutical products at maintenance were enrolled. Venous blood samples were drawn before the CBD morning dose, 12 h apart from the last evening dose (C0 or CBD trough concentration). A linear mixed-effect analysis was implemented to assess the correlation between C0 and clinical, laboratory, pharmacological, and lifestyle factors. Fifteen females and seven males with a median age of 12.8 years (ranging between 4.7 and 17.2) were included. The median CBD dose was 8.8 mg/kg/day (ranging between 2.6 and 22.5), and the CBD C0 median (range) was 48.2 ng/mL (3.5–366.3). The multivariate model showed a 109.6% increase in CBD C0 in patients with concomitant levothyroxine (β = 0.74 ± 0.1649, p < 0.001), 56.8% with food (β = 0.45 ± 0.1550, p < 0.01), and 116.0% after intake of a ketogenic diet (β = 0.77 ± 0.3141, p < 0.05). All patients included were responders without evidence of an association between C0 and response status. In children with DEEs, systemic concentrations of CBD may be significantly increased when co-administered with levothyroxine, food, or a ketogenic diet.

show abstract

Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Real-World Evidence of Factors Affecting Cannabidiol Exposure in Children with Drug-Resistant Developmental and Epileptic Encephalopathies

Brstilo,

Reyes Valenzuela,

Caraballo

et al. 2023

Pharmaceutics

View full text Add to dashboard Cite

show abstract

“…For example, in a study evaluating the use of VPA, CBZ and levetiracetam (LEV), thyroid dysfunction was frequent in children taking VPA or CBZ as a monotherapy, but absent in those taking LEV. The authors suggest that, in children with a predisposition for thyroid disease, LEV should be considered over VPA and CBZ, if appropriate for seizure and epilepsy type ( 204 ).…”

Section: Effects On Thyrotropin Releasing Hormone (Trh) and Tsh Levelsmentioning

confidence: 99%

An Overview on Different L-Thyroxine (l-T4) Formulations and Factors Potentially Influencing the Treatment of Congenital Hypothyroidism During the First 3 Years of Life

et al. 2022

View full text Add to dashboard Cite

Congenital hypothyroidism (CH) is a relatively frequent congenital endocrine disorder, caused by defective production of thyroid hormones (THs) at birth. Because THs are essential for the development of normal neuronal networks, CH is also a common preventable cause of irreversible intellectual disability (ID) in children. Prolonged hypothyroidism, particularly during the THs-dependent processes of brain development in the first years of life, due to delays in diagnosis, inadequate timing and dosing of levothyroxine (l-thyroxine or l-T4), the non-compliance of families, incorrect follow-up and the interference of foods, drugs and medications affecting the absorption of l-T4, may be responsible for more severe ID. In this review we evaluate the main factors influencing levels of THs and the absorption of l-T4 in order to provide a practical guide, based on the existing literature, to allow optimal follow-up for these patients.

show abstract

The Effect of Antiseizure Medications on Thyroid Functions in Children With Epilepsy

Cebeci,

Gurkas,

Aribas Oz

et al. 2024

Clin Pediatr (Phila)

View full text Add to dashboard Cite

In this study, we aimed to investigate the effects of antiseizure medications on serum thyroid-stimulating hormone (TSH), free thyroxin (fT4) levels, and the frequency of subclinical hypothyroidism in children with epilepsy. One hundred and eighty-one pediatric patients receiving valproate, phenobarbital, carbamazepine, and levetiracetam monotherapy were included. The serum TSH levels were significantly higher at 6th, 12th, and 18th months of the treatment compared with the pre-treatment levels in valproate-treated patients. Serum fT4 levels in carbamazepine group were significantly lower than levetiracetam, valproate, and phenobarbital groups at 12th and 18th months of the treatment. Serum fT4 and TSH levels in levetiracetam group showed no significant changes at any time point. The frequency of subclinical hypothyroidism at 18th month was 16% in valproate, 11% in phenobarbital, 7% in carbamazepine, and 0% in levetiracetam groups. Our data suggest that levetiracetam monotherapy does not cause thyroid dysfunction.

show abstract

Is the prevalence of thyroid disease higher in children receiving antiepileptic medication? A systematic review and meta-analysis

Cited by 5 publications

References 49 publications

Real-World Evidence of Factors Affecting Cannabidiol Exposure in Children with Drug-Resistant Developmental and Epileptic Encephalopathies

Real-World Evidence of Factors Affecting Cannabidiol Exposure in Children with Drug-Resistant Developmental and Epileptic Encephalopathies

An Overview on Different L-Thyroxine (l-T4) Formulations and Factors Potentially Influencing the Treatment of Congenital Hypothyroidism During the First 3 Years of Life

The Effect of Antiseizure Medications on Thyroid Functions in Children With Epilepsy

Contact Info

Product

Resources

About