Long-term antiepileptic drug effect on bone destiny in Thai pre-menopausal epileptic patiens comparing with aged matched healthy controls

Abstract

Objectives: To study whether there is significant adverse effect of long-term antiepileptic drug (AED) therapy on bone mineral density (BMD) in Thai ambulatory pre-menopausal epileptic patients in comparison with age range-matched healthy Thai pre-menopausal females. Design: cross sectional, analytical, observational study. Setting: Epilepsy Clinic at Siriraj Hospital, a tertiary care and training center Research Methodology: All pre-menopausal epileptic female patients aged 20-50 years receiving AEDs ≥ 3 years and age matched pre-menopausal healthy female were interviewed with a case record form according to inclusion and exclusion criteria as well as baseline characteristics. All eligible participants had physical exam, blood tests, urine exam and BMD measurement. Baseline characteristics and BMD of finally included patients and controls were then analyzed and compared. Results: 50 from eligible 57 epileptic patients and 51 from 63 participated controls were included. BMD at femur neck was significantly lower in patients with p=0.064, 95% CI -0.02 – 0.69. BMD at other sites, i.e. L 2-4, femur trochanter, femur total and radius 33% tended to lower in patient group. Proportion of osteopenia plus osteoporosis at L 2-4 and femur neck were significantly higher in patients, p = 0.014 and p = < 0.001 respectively. There was a trend of higher osteopenia-osteoporosis in patients at femur trochanter, femur total, radius UD, and radius 33% Conclusion: The study proved that AEDs had adverse effect on BMD resulting in decreased BMD after receiving ≥ 3 years in Thai pre-menopausal epileptic female patients who had no other disorders or drugs with BMD decreasing effect.