[Effect of topiramate and carbamazepine on bone metabolism in children with epilepsy]
Jing Zhang1, Kai-Xuan Wang, Yi Wei
1Department of Pediatrics, Jinghua Central Hospital, Jinghua, Zhejiang 321000, China.
Insights
Topiramate (TPM) and carbamazepine (CBZ) treatments in epileptic children may affect bone health. Both drugs were associated with reduced bone mineral density (BMD) and altered serum calcium and phosphorus levels compared to controls.
Area of Science:
- Pediatric Neurology
- Bone Metabolism
- Pharmacology
Background:
- Epilepsy treatment often involves antiepileptic drugs.
- Concerns exist regarding the impact of certain antiepileptic drugs on bone health in children.
- Topiramate (TPM) and carbamazepine (CBZ) are commonly prescribed antiepileptic medications.
Purpose of the Study:
- To evaluate the effects of topiramate (TPM) and carbamazepine (CBZ) on bone health in epileptic children.
- To compare bone mineral density (BMD) and biochemical markers of bone metabolism in children treated with TPM, CBZ, or no antiepileptic drugs.
Main Methods:
- A comparative study involving 63 epileptic children on TPM or CBZ and 36 epileptic children as controls.
- Bone mineral density (BMD) assessed using dual-energy X-ray absorptiometry (DXA) at the lumbar spine and radius-ulna.
- Serum levels of calcium, phosphorus, and alkaline phosphatase were measured as biochemical indices of bone metabolism.
Main Results:
- Serum calcium was higher in the TPM group and lower in the CBZ group compared to controls.
- Serum phosphorus levels were significantly lower in both TPM and CBZ groups versus the control group.
- Bone mineral density (BMD) was significantly reduced in children treated with either TPM or CBZ compared to the control group.
Conclusions:
- Topiramate (TPM) and carbamazepine (CBZ) treatment may lead to alterations in calcium, phosphorus, and alkaline phosphatase levels.
- Both TPM and CBZ are associated with a reduction in bone mineral density (BMD) in epileptic children.
- These findings highlight potential risks to bone health with long-term use of TPM and CBZ in pediatric epilepsy management.
Objective:
To assess bone health in epileptic children who have been treated with topiramate (TPM) or carbamazepine (CBZ).
Methods:
Sixty-three epileptic children who received TPM or CBZ treatment and 36 eileptic children who did not receive any drug treatment (control group) were enrolled. Bone mineral density (BMD) at lumbar vertebrae (L1-L4) and radius-ulna was evaluated by the dual-energy X-ray absorptiometry method. Biochemical indices of bone metabolism, including serum calcium, phosphorus and alkaline phosphatase contents were measured.
Results:
The serum calcium content was higher in the TPM group (2.41+/-0.17 mmol/L), but it was lower in the CBZ group (2.15+/-0.26 mmol/L) than that (2.26+/-0.11 mmol/L) in the control group (p<0.05). The serum phosphorus content in both the TPM (1.55+/-0.17 mmol/L) and the CBZ groups (1.52+/-0.26 mmol/L) was significantly lower than that in the control group (1.70+/-0.30 mmol/L) (p<0.05). There were no significant differences in the serum content of alkaline phosphatase between three groups. BMD was significantly reduced in both the TPM and the CBZ groups when compared to the control group (p<0.05).
Conclusions:
TPM and CBZ may result in alterations in serum contents of calcium, phosphorus and alkaline phosphatase as well as BMD reduction.
Related Concept Videos
01:17Antiepileptic Drugs: Calcium Channel Blockers
Calcium channel blockers exert their antiepileptic effects by targeting T-type calcium channels, which are integral to transmitting nerve signals in the central nervous system. These channels allow the passage of calcium ions, which are vital for neuronal communication. By inhibiting T-type calcium channels, calcium channel blockers effectively reduce the release of neurotransmitters and...
01:08Antiepileptic Drugs: Sodium Channel Blockers
Sodium channel blockers modulate ion channels, particularly voltage-gated sodium channels. They block only sodium ion movement.
Among the most commonly prescribed antiepileptic drugs are...
01:20Antiepileptic Drugs: Modulators of Neurotransmitter Release Mediated by SV2A Protein
SV2A is a transmembrane glycoprotein located predominantly in the brain, modulating the release of neurotransmitters for neuronal communication. Both levetiracetam and brivaracetam exhibit a high affinity for...
01:18Antiepileptic Drugs: GABAergic Pathway Potentiators
The key GABA pathway potentiators used in epilepsy management are as follows.
Benzodiazepines are a well-known class of drugs used for their...
01:14Antiepileptic Drugs: Glutamate Antagonists
01:20Antiepileptic Drugs: Potassium Channel Activators
Ezogabine has gained approval as an adjunctive treatment...