Evaluation of bone turnover in epileptic children using oxcarbazepine.
This study evaluated the effects of oxcarbazepine monotherapy on bone turnover in prepubertal and pubertal children. Thirty-four newly diagnosed pediatric patients with normal bone mineral density, serum biochemical markers of bone formation, and hormonal markers participated. Levels of 25-hydroxyvitamin D were significantly decreased after therapy compared with baseline values. Levels of gamma-glutamyl transferase, phosphorus, alkaline phosphatase, osteocalcin, parathyroid hormone, and calcitonin had increased. However, only changes in osteocalcin and gamma-glutamyl transferase levels were statistically significant compared with baseline values. Drug-induced osteopenia was evident in 3 patients with z scores of bone-mineral density less than -2.0, whereas these patients had z scores of less than -1.5 before treatment. Although 18 months of oxcarbazepine treatment exerted slightly adverse effects on bone metabolism, the effect seems insignificant in children with normal bone-mineral density. Although alterations in bone metabolism do not always suffice to explain the decrease in bone-mineral metabolism, we think that patients with osteopenia before the initiation of oxcarbazepine therapy should be followed carefully, especially in long-term treatment.
Cansu
Ali
A
Department of Pediatric Neurology, Gazi University School of Medicine, Ankara, Turkey.
Yesilkaya
Ediz
E
Serdaroğlu
Ayşe
A
Hirfanoğlu
Tuğba Lüleci
TL
Camurdan
Orhun
O
Gülbahar
Ozlem
O
Gücüyener
Kivilcim
K
Cinaz
Peyami
P
D000284:Administration, Oral; D000293:Adolescent; D000469:Alkaline Phosphatase / Q000097:blood; D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D015519:Bone Density / Q000187:drug effects*; D001851:Bone Diseases, Metabolic / Q000139:chemically induced* / Q000378:metabolism; D002116:Calcitonin / Q000097:blood; D002220:Carbamazepine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D002648:Child; D004827:Epilepsy; D006801:Humans; D015675:Osteocalcin / Q000097:blood; D010012:Osteogenesis / Q000187:drug effects*; D000078330:Oxcarbazepine; D010281:Parathyroid Hormone / Q000097:blood; D010758:Phosphorus / Q000097:blood; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D005722:gamma-Glutamylcyclotransferase / Q000097:blood
D000927:Anticonvulsants; D015415:Biomarkers; D010281:Parathyroid Hormone; D015675:Osteocalcin; D014807:Vitamin D; D010758:Phosphorus; D002220:Carbamazepine; D002116:Calcitonin; C104450:25-hydroxyvitamin D; D000469:Alkaline Phosphatase; D005722:gamma-Glutamylcyclotransferase; D000078330:Oxcarbazepine