Effects of AEDs on biomarkers in people with epilepsy: CRP, HbA1c and eGFR.
The standardised mortality ratio in people with epilepsy is raised to between 2 and 3 compared with the general population. Some biomarker levels, including higher C-reactive protein (CRP), higher glycosylated haemoglobin (HbA1c) and lower estimated glomerular filtration rate (eGFR), are associated with an increase risk of premature mortality. These biomarkers were measured in 125 people with refractory epilepsy to estimate the potential effect of antiepileptic drug (AED) use on these markers. Multiple regression analysis showed that valproate (N=50) use was associated with 55% lower mean CRP concentrations and higher mean eGFR values; and phenytoin (N=32) use with 4% lower mean HbA1c values. These potentially represent health markers improved by AEDs. On the other hand, lamotrigine use (N=48) was associated with 13% lower mean eGFR and this may represent a negative effect on a health marker. These preliminary observations clearly require further controlled studies ideally in people on AED monotherapy.
Yuen
Alan W C
AW
Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, United Kingdom. alan@yuen.co.uk
Bell
Gail S
GS
Peacock
Janet L
JL
Koepp
Matthias M
MM
Patsalos
Philip N
PN
Sander
Josemir W
JW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000009:adverse effects / Q000097:blood* / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D004827:Epilepsy / Q000097:blood* / Q000188:drug therapy / Q000401:mortality; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects / Q000502:physiology*; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D000077213:Lamotrigine; D008297:Male; D008875:Middle Aged; D014227:Triazines / Q000097:blood / Q000627:therapeutic use; D014635:Valproic Acid / Q000097:blood / Q000627:therapeutic use; D055815:Young Adult
D000927:Anticonvulsants; D015415:Biomarkers; D002097:C-Reactive Protein; D006442:Glycated Hemoglobin; D000077213:Lamotrigine; D014227:Triazines; D014635:Valproic Acid; C517652:hemoglobin A1c protein, human