Lipoprotein(a) concentration increases during treatment with carbamazepine.
OBJECTIVE
Treatment with carbamazepine (CBZ) is known to affect apolipoprotein B-containing lipoprotein concentrations in serum. However, little is known about the effects of anticonvulsant drugs (AEDs) on lipoprotein(a) [Lp(a)], although Lp(a) has been characterized as independent cardiovascular risk factor. We investigated prospectively the effect of CBZ on lipoprotein(a) concentration in normolipidemic healthy adults.


METHODS
Twenty male volunteers were included in the study. Lp(a) levels were determined before and 69 +/- 19 days after CBZ administration by using an enzyme-linked immunoassay.


RESULTS
CBZ (mean plasma concentration, 6.6 +/- 0.6 microg/ml) caused a significant increase in Lp(a) concentrations, with a median change of +19.5% (95% CI: +8.2, +53.3; p < 0.001). Total cholesterol, low density lipoprotein (LDL) cholesterol, and triglycerides also increased significantly.


CONCLUSIONS
Although the precise mechanism of action of CBZ on Lp(a) elevation remains uncertain, it might be related to its enzyme-inducing properties. During treatment with CBZ, special focus should be given to elevated LDL cholesterol and Lp(a) concentrations with regard to increased risk for atherosclerotic vascular diseases.
Brämswig
Suzanne
S
Department of Clinical Pharmacology, University of Bonn, Bonn, Germany.
Sudhop
Thomas
T
Luers
Claus
C
von Bergmann
Klaus
K
Berthold
Heiner K
HK
D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use; D002220:Carbamazepine / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use; D002784:Cholesterol / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood / Q000209:etiology; D003929:Diabetic Neuropathies / Q000188:drug therapy; D006801:Humans; D017270:Lipoprotein(a) / Q000097:blood*; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D013268:Stimulation, Chemical; D016683:Supine Position; D014280:Triglycerides / Q000097:blood
D000927:Anticonvulsants; D008078:Cholesterol, LDL; D017270:Lipoprotein(a); D014280:Triglycerides; D002220:Carbamazepine; D002784:Cholesterol