Early detection of bone metabolism changes under different antiepileptic drugs (ED-BoM-AED) - A prospective multicenter study

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• 作者：Sebastian Bauer ; Lorenz C. Hofbauer ; Martina Rauner ; Adam Strzelczyk ; Christoph Kellinghaus ; Susanne Hallmeyer-Elgner ; Wolfgang H. Oertel ; Felix Rosenow
• 关键词：Oxcarbazepine ; Valproate ; Bone turnover ; RANKL ; Osteoprotegerin
• 刊名：Epilepsy Research
• 出版年：2013
• 出版时间：October, 2013
• 年：2013
• 卷：106
• 期：3
• 页码：417-422
• 全文大小：540 K

文摘

| Figures/TablesFigures/Tables | ReferencesReferences<h3 class=""h3"">Summaryh3><h4 class=""h4"">Purposeh4>To determine early changes in bone turnover markers induced by treatment with oxcarbazepine or valproate.<h4 class=""h4"">Methodsh4>

In this prospective study, 31 adults with newly diagnosed epilepsy were included who were started on therapy with either oxcarbazepine (OXC, n = 16, mean age 45.6 years, 37.5 % female) or valproate (VPA, n = 15, mean age 42.2 years, 33.3 % female). Clinical characteristics were obtained at baseline, after 2 weeks and 3 months. In addition, blood samples were drawn at each visit. Calcium, phosphate, alkaline phosphatase (AP), receptor activator of NF-¦ÊB ligand (RANKL), osteoprotegerin (OPG), osteocalcin (OC) and cathepsin K were determined.<h4 class=""h4"">Resultsh4>

In OXC treated patients, OPG increased by 0.06 pmol/L (p = 0.0004) after 2 weeks and remained elevated by 0.05 pmol/L (p = 0.02) after 3 months. Between 2 weeks and 3 months of OXC treatment, OC increased by 1.98 ng/mL (p = 0.02). During the first 3 months of OXC treatment, total serum AP increased by 11 %  ¡À 9 % (p = 0.02). Compared to baseline, serum calcium raised by 0.06 mmol/L (p = 0.04) after 2 weeks and by 0.07 mmol/L (p = 0.004) after 3 months of OXC treatment. In VPA treated patients, a late OPG increase by 0.07 pmol/L (p = 0.007) occurred after 3 months. During the first 3 months of OXC treatment, total serum AP decreased by by 7 %  ¡À 15 % (p = 0.03). No changes in OC or calcium were seen. RANKL was below detection limit in 16 out of 31 patients (52? % ) and did not change significantly during treatment. Cathepsin K was below detection limit at baseline in 27 out of 31 patients (87 % ) and was therefore not further evaluated. Phosphate did not change during treatment.<h4 class=""h4"">Conclusionh4>

Increased bone turnover can be measured within few weeks of newly started treatment with OXC, while significant changes under VPA treatment occurred only after 3 months. Our data suggest distinct mechanisms of increased bone turnover in different anticonvulsants. These variable mechanisms may require individual prevention and treatment strategies.