Effects of antiepileptic drugs on bone mineral density and bone metabolism in children: a meta-analysis

J Zhejiang Univ Sci B. 2015 Jul;16(7):611-21. doi: 10.1631/jzus.B1500021.

Abstract

Objective: The aim of our meta-analysis was to assess the effects of antiepileptic drugs on bone mineral density and bone metabolism in epileptic children.

Methods: Searches of PubMed and Web of Science were undertaken to identify studies evaluating the association between antiepileptic drugs and bone mineral density and bone metabolism.

Results: A total of 22 studies with 1492 subjects were included in our research. We identified: (1) a reduction in bone mineral density at lumbar spine (standardized mean difference (SMD)=-0.30, 95% confidence interval (CI) [-0.61, -0.05]), trochanter (mean difference (MD)=-0.07, 95% CI [-0.10, -0.05]), femoral neck (MD=-0.05, 95% CI [-0.09, -0.02]), and total body bone mineral density (MD=-0.33, 95% CI [-0.51, -0.15]); (2) a reduction in 25-hydroxyvitamin D (MD=-3.37, 95% CI [-5.94, -0.80]) and an increase in serum alkaline phosphatase (SMD=0.71, 95% CI [0.38, 1.05]); (3) no significant changes in serum parathyroid hormone, calcium, or phosphorus.

Conclusions: Our meta-analysis suggests that treatment with antiepileptic drugs may be associated with decreased bone mineral density in epileptic children.

Keywords: Antiepileptic drugs; Bone metabolism; Bone mineral density; Children; Meta-analysis.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adolescent
  • Anticonvulsants / administration & dosage*
  • Anticonvulsants / adverse effects
  • Bone Density / drug effects*
  • Bone Diseases, Metabolic / chemically induced*
  • Bone Diseases, Metabolic / epidemiology
  • Bone Diseases, Metabolic / metabolism*
  • Bone and Bones / drug effects
  • Bone and Bones / metabolism*
  • Child
  • Child, Preschool
  • Dose-Response Relationship, Drug
  • Epilepsy / drug therapy
  • Epilepsy / epidemiology
  • Epilepsy / physiopathology
  • Female
  • Humans
  • Male
  • Treatment Outcome

Substances

  • Anticonvulsants