Valproate decreases vitamin D levels in pediatric patients with epilepsy
Zejun Xu1, Xia Jing1, Guizhou Li2
1Department of Pharmacy, Children's Hospital of Nanjing Medical University, Nanjing, China.
Insights
Children on long-term valproate therapy for epilepsy show decreased Vitamin D (Vit D) levels. Monitoring and supplementation of Vit D are recommended for these pediatric patients.
Area of Science:
- Pediatric Neurology
- Nutritional Biochemistry
Background:
- Epilepsy is a common neurological disorder in children.
- Valproate is a widely used antiepileptic drug.
- Vitamin D deficiency is a growing concern in pediatric populations.
Purpose of the Study:
- To compare Vitamin D levels in children with epilepsy on valproate monotherapy versus healthy controls.
- To evaluate the impact of valproate monotherapy on Vitamin D status in pediatric epilepsy patients.
Main Methods:
- A comprehensive meta-analysis of studies from PubMed and Web of Science.
- Inclusion of 11 publications meeting predefined criteria.
- Utilized NIH Study Quality Assessment Tools for evaluation.
Main Results:
- Children with epilepsy on valproate monotherapy exhibited significantly lower Vitamin D levels (SMD = -0.313).
- Cumulative analysis revealed a time-dependent negative effect of valproate on Vitamin D.
- Other antiepileptic drugs also demonstrated an impact on Vitamin D status.
Conclusions:
- Long-term valproate therapy in children is associated with decreased Vitamin D levels.
- Routine monitoring of 25-OH-Vit D is crucial for pediatric patients on long-term valproate.
- Timely Vitamin D supplementation should be considered for deficient levels in this cohort.
Purpose:
To compare Vitamin D (Vit D) levels in children with epilepsy on valproate monotherapy with healthy controls.
Methods:
A meta-analysis performed on articles identified from PubMed and Web of Science online databases evaluated using National Institute of Health National Heart, Lung, and Blood Institute Study Quality Assessment Tools. Subgroup analyses and publication bias assessments were also performed.
Results:
Eleven publications were eligible based on inclusion/exclusion criteria for the meta-analysis. Results noted a decrease in the mean Vit D level in children with epilepsy on valproate monotherapy compared with healthy children with a Standard Mean Difference = -0.313 [-0.457, -0.169]. Cumulative meta-analysis showed progressive negative effect of valproate therapy on Vit D levels across time. Other antiepileptic medications caused a similar effect on Vit D status. There was no evidence of publication bias in the analyses. Type of study design and country of origin introduced heterogeneities into the meta-analyses.
Conclusion:
This meta-analysis provides evidence that long-term therapy with valproate causes a decrease in Vit D levels in children. Therefore, in children with a seizure disorder on long-term valproate therapy, 25-OH-Vit D levels should be monitored and appropriate supplementation implemented if levels are deficient.
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