Â鶹´«Ã½Ó³»­

Â鶹´«Ã½Ó³»­

Explore the latest content from across our publications
Join The Â鶹´«Ã½Ó³»­

Log In

Forgot Password?
Create New Account

Loading... please wait

Abstract Details

A severe bone loss in pharmacoresistant epilepsy associates with enzyme-inducing antiepileptic drug
Epilepsy/Clinical Neurophysiology (EEG)
P1 - Poster Session 1 (5:30 PM-6:30 PM)
6-006

Evaluate the reduction of bone mineral density (BMD) in pharmacoresistant patients exposed to enzyme-inducing antiepileptic drug (EIAED) in Brazil.

Although studies have demonstrated reduced levels of Vitamin-D in patients taking enzyme-inducing antiepileptic drug (EIAED), controversies persist in the bone effects of EIAED.

We examined BMD (according to 2007 ISCD position (https://www.iscd.org/official-positions/2007-iscd-official-positions-adult/) from 59 consecutive adults (41 women, median of 57 years, (range 25-76), duration of epilepsy 45 years) with pharmacoresistant epilepsy who were receiving (or had received) EIAED. Forty-seven subjects aged >50years (>=50y, 41 women). Time of exposure to individual EIAED (median in years, carbamazepine (18years), phenytoin (10.5years) and phenobarbital (4.5years)) was determined and combined as “total-time” (median24years).

Overall, T-score for the femoral neck was -1.2 and -1.55 for the spine.

 We identified abnormal BMD in 42 patients (BMD-POS, 25 osteoporosis, and 17 osteopenia). Compared to patients with normal BMD (17 BMD-NL), both groups were balanced for age (p=0.6), sex (p=0.9), race (p=0.26), number of EIAED (p=0.78) and total-time (p=0.7). Among those with osteoporosis, five subjects presented fractures. Abnormal BMD was detected in 71% of post-menopausal women (25/35), divided in osteoporosis (14/35) and osteopenia (11/35).

Considering Group<50-years (9women/3men), osteoporosis was present in 33% and 22% of men and women, respectively. Osteopenia arose in 44% of women. Unfortunately, in the Group>=50years, BMD abnormalities (osteopenia or osteoporosis) occurred in 72% of men (11/15) and 73% of women (23/32). Osteoporosis was diagnosed in 53 and 56% of men and women, respectively.
Compared to the expected prevalence of hip osteoporosis (according to World Health Organization) for men (2%) and women (16%) aged ≥50 years, we observed higher proportion (around 50% for men and women) in our study. These preliminary results suggest a severe impact of EIAED on bone density, and alert for the urgent need of a specific policy and guideline to avoid fractures.
Authors/Disclosures
Amanda C. Rigotti, MD
PRESENTER 		No disclosure on file
Leticia Franceschet Ribeiro No disclosure on file
Marcia E. Morita-Sherman, MD (Eisai) An immediate family member of Dr. Morita-Sherman has received personal compensation for serving as an employee of Forrester Research. Dr. Morita-Sherman has received personal compensation for serving as an employee of Eisai Inc.. An immediate family member of Dr. Morita-Sherman has stock in Forrester Research. The institution of Dr. Morita-Sherman has received research support from Cleveland Clinic.
Marina K. Alvim (Hospital Das Clinicas Unicamp) Dr. Alvim has nothing to disclose.
No disclosure on file
Carlos A. Guerreiro, MD, FÂ鶹´«Ã½Ó³»­ No disclosure on file
Fernando Cendes, MD, PhD, FÂ鶹´«Ã½Ó³»­ (Departamento de Neurologia; FCM; UNICAMP) Dr. Cendes has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB Pharma. Dr. Cendes has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for UCB Biopharma. Dr. Cendes has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for United Medical – Brazil. Dr. Cendes has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Zodiac Pharma . Dr. Cendes has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Eurofarma – Brazil . Dr. Cendes has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Epilepsia. Dr. Cendes has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Frontiers in Neurology - Epilepsy. The institution of Dr. Cendes has received research support from São Paulo Research Foundation - FAPESP. The institution of Dr. Cendes has received research support from Conselho Nacional de Desenvolvimento Científico e Tecnológico - Brazil . The institution of Dr. Cendes has received research support from NIH.
Clarissa L. Yasuda, MD, PhD (University of Campinas) Prof. Yasuda has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for LIBBS. Prof. Yasuda has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for ABBOTT. Prof. Yasuda has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for LIBBS.