Two randomized vitamin D trials in ambulatory patients on anticonvulsants: impact on bone.
OBJECTIVE
To investigate the effects of two doses of vitamin D given over 1 year on bone density in ambulatory patients on long-term antiepileptic drug (AED) therapy.


METHODS
We conducted two parallel, randomized, controlled trials in 72 adults (18 to 54 years old) and 78 children and adolescents (10 to 18 years) on long-term AED therapy. They received either low-dose vitamin D 400 IU/day or high-dose vitamin D 4,000 IU/day (adults) and 2,000 IU/day (children/adolescents). Bone mineral density (BMD) was measured using dual-energy x-ray absorptiometry.


RESULTS
In adults, baseline BMD was lower than that of age- and gender-matched controls vs either a Western or an ethnically identical population. After 1 year, there were significant increases in BMD at all skeletal sites compared to baseline in the high-, but not in the low-dose treatment group. However, BMD at 1 year remained below normal. In children, baseline BMD was normal vs age- and gender-matched controls and showed significant and comparable increases in both treatment groups.


CONCLUSIONS
In ambulatory adults on antiepileptic drugs, high-dose vitamin D therapy substantially increased bone mineral density at several skeletal sites. In children, both doses resulted in comparable increases in bone mass.
Mikati
M A
MA
Adult and Pediatric Epilepsy Program, Department of Pediatrics, American University of Beirut Medical Center, Beirut, Lebanon. mamikati@aub.edu.lb
Dib
L
L
Yamout
B
B
Sawaya
R
R
Rahi
A C
AC
Fuleihan
G El-Hajj
Gel-H
D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care / Q000379:methods*; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D015519:Bone Density / Q000187:drug effects* / Q000502:physiology; D001847:Bone Diseases / Q000139:chemically induced / Q000517:prevention & control; D002648:Child; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004827:Epilepsy / Q000150:complications / Q000188:drug therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014807:Vitamin D / Q000494:pharmacology* / Q000627:therapeutic use
D000927:Anticonvulsants; D014807:Vitamin D