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Bone loss with antiepileptic drug therapy: A twin and sibling study
Ahmad, B. Shiek Petty, Sandra J. Gorelik, Alex O'Brien, Terence J. Hill, K. D. Christie, J. J. Sambrook, Philip N. Wark, John D.
Ahmad, B. Shiek
Petty, Sandra J.
Gorelik, Alex
O'Brien, Terence J.
Hill, K. D.
Christie, J. J.
Sambrook, Philip N.
Wark, John D.
Abstract
Summary Changes in areal bone mineral density (aBMD) and other predictors of bone loss were evaluated in 48 same-sex twin/age-matched sibling pairs discordant for antiepileptic drug (AED) use. AED users had reduced BMD at the hip regions. Prolonged AED users had greater aBMD loss, predicting a higher risk of bone fragility. Introduction To investigate the longitudinal associations of bone mineral measures with antiepileptic drug (AED) use, including enzyme-inducing (EIAED) and non-enzyme-inducing (NEIAED) types, and other predictors of bone loss in a study of 48 same-sex twin/age-matched sibling pairs (40 female, 8 male) discordant for AED use. Methods Using dual-energy X-ray absorptiometry (DXA), areal bone mineral density (aBMD) and content (BMC) at the hip regions, forearm, lumbar spine, and whole body were measured twice, at least 2 years apart. The mean within-pair difference (MWPD), MWPD%, and mean annual rate of aBMD change were adjusted for age, weight, and height. Predictors of bone loss were evaluated. Results AED users, compared to non-users, at baseline and follow-up, respectively, had reduced aBMD at the total hip (MWPD% 3.8, 4.4%), femoral neck (4.7, 4.5%), and trochanter regions (4.1, 4.6%) (p < 0.05). For the whole cohort, the annual rate of change in all aBMD/BMC (p > 0.05) regions did not differ within pairs. Nevertheless, EIAED users had greater aBMD loss than non-users (n = 20 pairs) at the total hip (1.7 vs. 0.3%, p = 0.013) and whole body regions (0.7% loss vs. 0.1% BMD gain, p = 0.019), which was not found in NEIAED-discordant pairs (n = 16). AED use >20 years predicted higher aBMD loss at the forearm (p = 0.028), whole body (p = 0.010), and whole body BMC (p = 0.031). Conclusions AED users had reduced aBMD at the hip regions. Prolonged users and EIAED users had greater aBMD loss, predicting a higher risk of bone fragility. Further prospective studies of AED effects on bone microarchitecture are needed.
Keywords
antiepileptic drug, bone mineral density (BMD), dual-energy x-ray absorptiometry (DXA), epilepsy, longitudinal study
Date
2017
Type
Journal article
Journal
Osteoporosis International
Book
Volume
28
Issue
9
Page Range
2591-2600
Article Number
ACU Department
Relation URI
Source URL
Event URL
Open Access Status
License
File Access
Controlled