Anticonvulsant drug use and low bone mass in adults with neurodevelopmental disorders.
BACKGROUND
Use of anticonvulsant drugs among adults with neurodevelopmental disorders may be an important risk factor for both osteoporosis and skeletal fractures.


OBJECTIVE
To determine the relationship between anticonvulsant drug use and both low bone mass and bone fractures in such adults.


METHODS
Cross-sectional study of 273 adults with neurodevelopmental disorders, 40% of whom were receiving one or more anticonvulsant drugs.


METHODS
Single Canadian long-term care facility.


METHODS
Demographic data were abstracted from each resident's chart in a standardized manner, including body mass, degree of mobility, major falls within the previous 12 months, and all medications. Quantitative calcaneal ultrasonography was performed on each resident without knowledge of their current drug use. The Quantitative Ultrasound Index was employed to express 'bone stiffness'. Low bone mass was defined as a T-score 2.5 SDs below the norm for young healthy adults.


RESULTS
Compared to non-users (15.5%), low bone mass was more prevalent among those taking either one (20.3%; OR 1.7, 95%CI 0.6-4.4) or two or more anticonvulsant agents (42.2%, OR 5.9, 95%CI 2.2-16.2). The risk of recent skeletal fractures was not significantly greater in those taking a single anticonvulsant than in non-users (28.6% vs. 21.6%; OR 1.0, 95%CI 0.4-2.8), but tended to be higher in those taking two or more (48.7%; OR 2.2, 95%CI 0.8-5.9).


CONCLUSIONS
Adults with neurodevelopmental disorders residing in a long-term care facility have a high rate of both low bone mass and skeletal fractures, especially with concomitant use of anticonvulsant drugs. These individuals should be assessed for the presence of low bone mass, and may warrant prophylactic treatment against bone loss, including calcium and vitamin D supplementation.
Ray
J G
JG
Sunnybrook and Women's College Health Science Centre, Toronto, Canada. rayjg@mcmaster.ca
Papaioannou
A
A
Ioannidis
G
G
Adachi
J D
JD
D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities; D004359:Drug Therapy, Combination; D005260:Female; D050723:Fractures, Bone / Q000139:chemically induced; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010024:Osteoporosis / Q000139:chemically induced*; D012307:Risk Factors
D000927:Anticonvulsants