Prevalence and risk factors of low bone mineral density and 25-hydroxyvitamin D status in young healthy epileptic adult patients in a tropical Asian country taking antiepileptic drug

Enzyme-inducing antiepileptic drugs and fractures in people with epilepsy: A systematic review

“…Unfortunately, most studies did not state the actual dose of the medications used, and therefore it is unclear whether consistent use of this 200 mg/day cut-off was applied by all authors. As a result, several of the studies that were included in the final review categorized topiramate as an EIAED (Espinosa et al, 2011;Heo et al, 2011;Nicholas et al, 2013), and several as a non-EIAED (Fuleihan et al, 2008;Phabphal et al, 2009;Stephen et al, 1999). Another AED subtlety involves valproate, which is known to be an enzyme inhibitor (Gunes et al, 2007).…”

“…Of the 10 studies that included bone mineral density as an outcome (Fuleihan et al, 2008;Heo et al, 2011;Pack et al, 2008;Phabphal et al, 2009Phabphal et al, , 2013Salimipour et al, 2013;Sato et al, 2001;Sivaraaman and Jacobson, 2009;Srivastava and Jain, 2001;Stephen et al, 1999), 5 (n = 433 individuals; 2 cohort, and 3 cross sectional studies) found decreased (or decreasing) BMD values in PWE on EIAEDs compared to non-EIAEDs, whereas 5 studies (n = 405; 1 case control, and 4 cross sectional) showed no effect of AED type on BMD ( Table 2). The methodology and outcome definitions of these 10 studies were markedly heterogeneous, with some studies reporting a change in BMD over a one year period, and other studies simply measuring BMD once in all patients and then comparing the differences between groups.…”

“…A total of 68,973 adult PWE were included in the 13 studies: 7 cross sectional studies representing 596 patients (Fuleihan et al, 2008;Heo et al, 2011;Phabphal et al, 2009;Salimipour et al, 2013;Sato et al, 2001;Sivaraaman and Jacobson, 2009;Srivastava and Jain, 2001), 4 cohort studies representing 66,726 patients (Espinosa et al, 2011;Nicholas et al, 2013;Pack et al, 2008;Phabphal et al, 2013), 1 case control study of 78 patients (Stephen et al, 1999), and 1 nested case control study representing 1573 patients (Souverein et al, 2006b). The majority of studies (7 of 13) were from Asia/the Middle East; 3 studies were from North America; and 3 studies were from Europe.…”

Molecular mechanisms responsible for the impact of antiepileptic therapy on bone mineral density of epileptic patients

“…Доказано, что политерапия и длительность лечения ПЭП являются факторами риска снижения МПК [5,35,68,69], увеличения риска развития переломов и других нежела-тельных явлений, которые негативно влияют на качество жизни больных эпилепсией [59,70]. В исследовании G. ElHajj Fuleihan и соавт.…”

Gender specific association of decreased bone mineral density in patients with epilepsy

“…Low bone mineral density (BMD) is rare in young adults and either occurs in pregnant females as transient osteoporosis [1,2] or in both sexes in certain diseases such as multiple sclerosis [3,4], chronic glucocorticoid administration or immobility [4], stroke [5], and epilepsy [6,7].…”