[P2-129] Effect of Topiramate on Bone Metabolism in Children
(Background( Antiepileptic drugs (AEDs) may affect bone metabolism and increase risk for low bone mineral density (BMD) and metabolic bone disease. Topiramate (TPM) has been widely integrated into AED list for treatment of children with epilepsy for almost two decades. Yet, there are a few studies of its effect on BMD and bone metabolism.
(Objectives( To determine the changes in biochemical markers of bone metabolism in children who received topiramate monotherapy.
(Material and Methods( Epileptic patients aged 5 – 18 years, who received TPM monotherapy for minimum period of 6 months, were enrolled into this study. Each had measurement of BMD of total body less head at date of enrolment and blood collection for analysis of the markers of bone metabolism at date of enrolment, 3 months and 6 months. Assessment of dietary intakes and sun-exposure were determined by self-record and questionnaire.
(Results( 12 patients were included in the study. Serum phosphate levels significantly declined in these patients (p= 0.028). All of patients had 25(OH)D level below 30 ng/mL. They received vitamin D supplement, then. After the supplement, 25(OH)D level was significantly increased (p=0.001). There were no significantly changes of bone resorption and bone formation markers. Baseline BMD of all patient were within the expected range for age (Z-score -1.5 to 0.3).
(Conclusion( This preliminary study demonstrated vitamin D insufficiency and significantly declined serum phosphate in all patients who received TPM monotherapy. Further study in large group on the long-term effect of TPM on bone metabolism would provide more information.
(Objectives( To determine the changes in biochemical markers of bone metabolism in children who received topiramate monotherapy.
(Material and Methods( Epileptic patients aged 5 – 18 years, who received TPM monotherapy for minimum period of 6 months, were enrolled into this study. Each had measurement of BMD of total body less head at date of enrolment and blood collection for analysis of the markers of bone metabolism at date of enrolment, 3 months and 6 months. Assessment of dietary intakes and sun-exposure were determined by self-record and questionnaire.
(Results( 12 patients were included in the study. Serum phosphate levels significantly declined in these patients (p= 0.028). All of patients had 25(OH)D level below 30 ng/mL. They received vitamin D supplement, then. After the supplement, 25(OH)D level was significantly increased (p=0.001). There were no significantly changes of bone resorption and bone formation markers. Baseline BMD of all patient were within the expected range for age (Z-score -1.5 to 0.3).
(Conclusion( This preliminary study demonstrated vitamin D insufficiency and significantly declined serum phosphate in all patients who received TPM monotherapy. Further study in large group on the long-term effect of TPM on bone metabolism would provide more information.