What Is the Effect of Topiramate Use on Growth in Children With Epilepsy?
Muhammad T Alrifai1,2,3, Noura A Alsubaie2, Albatool M Abodarahem2
1Pediatrics Department, Neurology Division, King Abdullah Specialized Children's Hospital, King Abdulaziz Medical City, Riyadh, SAU.
Insights
Topiramate (TPM) does not negatively impact height growth in pediatric epilepsy patients. While some children experience mild weight loss initially, weight typically resumes increasing after the first year, especially for those with a normal BMI.
Area of Science:
- Pediatric Neurology
- Epileptology
- Pharmacology
Background:
- Inconsistent literature exists regarding topiramate's effect on weight in pediatric epilepsy patients.
- Understanding topiramate's impact on growth is crucial for managing pediatric epilepsy.
- Assessing weight changes is important for long-term treatment adherence and patient outcomes.
Purpose of the Study:
- To evaluate the effect of topiramate on the growth parameters of pediatric epileptic patients.
- To compare the growth outcomes of patients treated with topiramate versus other antiepileptic drugs.
- To investigate potential differences in weight changes based on initial Body Mass Index (BMI).
Main Methods:
- Retrospective review of medical records for 50 pediatric epileptic patients treated with topiramate.
- Comparison with a control group of 60 pediatric epileptic patients on other antiepileptic drugs.
- Analysis of height and Body Mass Index (BMI) changes over a one-year follow-up period.
Main Results:
- Height growth was comparable between the topiramate and control groups.
- Topiramate group showed a decrease in average BMI (-0.81 kg/m2) at 6-12 months, while the control group increased (+0.46 kg/m2).
- Weight loss occurred in 42% of the topiramate group versus 22% in the control group. Overweight patients on topiramate experienced more weight loss (44%).
- After one year, average weight gain was +1.73 kg in the topiramate group and +3.53 kg in the control group.
- Patients with normal initial BMI gained weight (+1.3 kg), while those with high initial BMI lost weight (-2.55 kg).
Conclusions:
- Topiramate does not adversely affect height growth in pediatric epilepsy patients.
- Mild weight loss is a common side effect of topiramate in the first year, but weight gain usually resumes.
- Patients with a high initial BMI may experience continued weight loss on topiramate, necessitating careful monitoring.
Abstract:
Objective The literature related to weight loss as a side effect of using topiramate (TPM) in pediatric patients is inconsistent. The aim of this study was to assess the effect of TPM on the growth of pediatric epileptic patients. Methods The electronic medical files of 50 pediatric epileptic patients who were prescribed TPM over 5 years were retrospectively reviewed. Cases treated with other antiepileptic drugs were the control group (n=60). Results Height growth was similar in both groups. At the 6-12-month follow-up, there was a decrease in the average BMI in the TPM group of -0.81 kg/m2 (p=0.019) and an increase in the control group of +0.46 kg/m2 (p=0.023). Weight loss was noted in 21/50 (42%) of the TPM group as compared with 13/60 (22%) in the control group (p=0.02). More weight loss was observed in the overweight TPM group in 7/16 (44%) compared to none in the nine cases in the control group (p=0.03). After the one-year follow-up, the average change in weight was +1.73 kg (p=0.0001) and +3.53 kg (p=0.0001) in the TPM and control groups, respectively. In patients with normal initial BMI, the weight increased by +1.3 kg on average, compared to the group with a high initial BMI, which decreased by -2.55 kg. Conclusion Topiramate use has no negative effect on height growth in pediatric patients with epilepsy. While mild weight loss occurs frequently in the first year of treatment, weight gain resumes after the first year except in patients with a high initial BMI.
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