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Horm Metab Res 2019; 51(08): 511-521
DOI: 10.1055/a-0963-0054
Endocrine Care
© Georg Thieme Verlag KG Stuttgart · New York

Effects of Second-Generation Antiepileptic Drugs Compared to First-Generation Antiepileptic Drugs on Bone Metabolism in Patients with Epilepsy: A Meta-Analysis

Jie Fu
1   Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
2   Department of Neurology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
,
Lilei Peng
3   Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
,
Jinglun Li
2   Department of Neurology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
,
Tao Tao
2   Department of Neurology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
,
Yangmei Chen
1   Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
› Author Affiliations
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Publication History

received 09 December 2018

accepted 12 June 2019

Publication Date:
13 August 2019 (online)

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Abstract

We conducted this meta-analysis to evaluate effects of second-generation anti-epileptic drugs (AEDs; levetiracetam, lamotrigine) compared to first-generation AEDs (valproic acid, carbamazepine) on bone metabolism in epilepsy patients. PubMed, Web of Science, Clinical trials.gov, Wanfang, and China national knowledge infrastructure databases were searched. Ten trials were included. Results showed: (1) The overall SMD for changes of serum calcium, phosphorus, ALP, and PTH levels from baseline of LEV versus first-generation AEDs were 1.00 (95% CI=0.23–1.77, Z=2.56, p=0.01), 0.98 (95% CI=− 0.05 to 2.01, Z=1.86, p=0.06), − 1.17 (95% CI=− 2.08 to − 0.25, Z=2.50, p=0.01), 0.07 (95% CI=− 0.14 to 0.27, Z=0.63, p=0.53), respectively. (2) The overall SMD for changes of serum calcium, phosphorus, ALP, and PTH levels from baseline of LTG versus first-generation AEDs were −0.16 (95% CI=− 0.47 to 0.16, Z=0.99, p=0.32), −0.05 (95% CI=− 0.55 to 0.44, Z=0.22, p=0.83), 0.10 (95% CI=− 0.53 to 0.73, Z=0.31, p=0.75), −0.05 (95% CI=− 0.52 to 0.42, Z=0.22, p=0.83), respectively. Overall, our results indicate that compared to first-generation AEDs, LEV has less adverse effects on blood bone metabolism markers in epilepsy patients, while LTG does not. However, due to small number of included studies, our results warrant additional research.

Key words

antiepileptic drugs - epilepsy - therapy - bone metabolism

Supplementary Material

 

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