title: Preliminary evidence for gender effects of levetiracetam monotherapy duration on bone health of patients with epilepsy.
abstract: Enzyme-inducing antiepileptic drugs AEDs have adverse effects on bone mineral density (BMD), whereas studies on levetiracetam (LEV), a nonenzyme-inducing agent, have showed conflicting results. The aim of this study was to further elucidate the role of LEV in bone health. A sample of forty-six patients with epilepsy (mean age: 35.7 years, range: 20.2-64.2 years, 39.1% males) on LEV monotherapy for at least one year (range: 1.5-14.5 years, median 5.5 years) underwent femoral neck (FN) and lumbar spine (LS) BMD measurements. The T- and Z-scores were calculated. Results showed that 15.2% of the patients were identified with osteopenia and none with osteoporosis. Pearson's correlations revealed a negative but not significant association of LEV duration with bone-related measurements (range of rhos: from -0.004 to -0.23), except for LS T-scores. In terms of FN BMD measurements, Z-scores, and T-scores, longer LEV therapy duration had adverse but not significant effects on bone health after adjusting for age and gender. With regard to LS BMD measurements, Z-scores, and T-scores, men taking LEV for at least 5.5 years had better, although not significant, bone health compared with men with shorter LEV exposure, after adjusting for age. The opposite was found in women, although differences did not reach significance. These preliminary results are indicative of a differential effect of LEV therapy duration in men and women, which could presumably account for the incongruity of the already published studies. Also, LS assessments were more sensitive to these gender differences. Future larger studies should validate these results.
authors.affiliation: First Department of Neurology, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Vasilissis Sophias Ave., 72-74, GR11528 Athens, Greece; Department of Neurology, 417 NIMTS Hospital, Monis Petraki Str., 10-12, GR11521 Athens Greece. Electronic address: kmwartem@yahoo.com.
authors.forename: Artemios K
authors.initials: AK
authors.lastname: Artemiadis
authors.affiliation: 2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, School of Medicine, National and Kapodistrian University of Athens, Vasilissis Sophias Ave., 76, GR11528 Athens, Greece. Electronic address: ilambrinoudaki@hotmail.com.
authors.forename: Irene
authors.initials: I
authors.lastname: Lambrinoudaki
authors.affiliation: First Department of Neurology, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Vasilissis Sophias Ave., 72-74, GR11528 Athens, Greece. Electronic address: p.voskou@yahoo.gr.
authors.forename: Panagiota
authors.initials: P
authors.lastname: Voskou
authors.affiliation: 2nd Department of Neurology, Attiko Hospital, School of Medicine, National and Kapodistrian University of Athens, Rimini Str., 5, GR12243 Athens, Greece. Electronic address: tsivgoulisgiorg@yahoo.gr.
authors.forename: Georgios
authors.initials: G
authors.lastname: Tsivgoulis
authors.affiliation: 2nd Department of Neurology, Attiko Hospital, School of Medicine, National and Kapodistrian University of Athens, Rimini Str., 5, GR12243 Athens, Greece. Electronic address: safouris@yahoo.com.
authors.forename: Apostolos
authors.initials: A
authors.lastname: Safouris
authors.affiliation: First Department of Neurology, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Vasilissis Sophias Ave., 72-74, GR11528 Athens, Greece. Electronic address: annita139@yahoo.gr.
authors.forename: Anastasia
authors.initials: A
authors.lastname: Bougea
authors.affiliation: First Department of Neurology, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Vasilissis Sophias Ave., 72-74, GR11528 Athens, Greece. Electronic address: sgiannop@uoi.gr.
authors.forename: Sotiris
authors.initials: S
authors.lastname: Giannopoulos
authors.affiliation: Neurosurgical Clinic, Evangelismos Hospital, School of Medicine, National and Kapodistrian University of Athens, Ipsiladou Str., 45, GR10676 Athens, Greece. Electronic address: sgatzon@med.uoa.gr.
authors.forename: Stergios
authors.initials: S
authors.lastname: Gatzonis
authors.affiliation: First Department of Neurology, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Vasilissis Sophias Ave., 72-74, GR11528 Athens, Greece. Electronic address: nik.triantaf@gmail.com.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Triantafyllou
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects; D015519:Bone Density / Q000187:drug effects* / Q000502:physiology; D015331:Cohort Studies; D004334:Drug Administration Schedule; D004827:Epilepsy / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D005260:Female; D006304:Health Status; D006801:Humans; D000077287:Levetiracetam; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000139:chemically induced / Q000000981:diagnostic imaging; D010889:Piracetam / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D011859:Radiography; D012189:Retrospective Studies; D012727:Sex Characteristics; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D000077287:Levetiracetam; D010889:Piracetam
keywords: Bone; Density; Levetiracetam; Mineral; Osteopenia; Osteoporosis