מתוך medicontext.co.il
By Joene Hendry
NEW YORK (Reuters Health) – In a cohort of young adults with epilepsy, those exposed to the hepatic enzyme inhibitor valproate for 5 years or longer were more likely to have abnormal bone density than those taking hepatic-enzyme inducing anti-epileptic drugs (EIAED's) for the same length of time, according a report presented last week at the American Epilepsy Society meeting in Philadelphia.
Seventy-one percent of those taking valproate "had abnormal bones" compared with 36% taking EIAED's, Dr. Joyce Liporace of Thomas Jefferson University in Philadelphia told Reuters Health.
Dr. Liporace and colleagues performed dual-energy X-ray absorptiometry (DEXA) scans and measured bone mineral density (BMD) at the spine (L1 through L4) and hip in 102 patients, 40 years old and younger, who had epilepsy for a mean 15.6 years. Patients with chronic exposure to glucocorticoids, reduced ambulation, and thyroid or renal disease were excluded from the study population.
"The overall risk of metabolic bone disease in the study population was 34%," Dr. Liporace said, but there was a trend for men to be more frequently affected. Of the 29 men studied, 48% had metabolic bone disease (10 with osteopenia and 4 with osteoporosis). Conversely, the investigators found metabolic bone disease in 29% of the women (21 of 73), including 19 with osteopenia and 2 with osteoporosis.
Dr. Liporace's group also found that a lower body mass index, independent of gender, was associated with an increased risk of bone disease.
Women are often only screened for bone disease at menopause, Dr. Liporace said, "and most men are never screened." She and colleagues recommend that patients exposed to any anti-epileptic drug for 5 years undergo DEXA scan screening for bone disease. She noted that earlier screening might be appropriate in those with a low body mass index.
תגובות רוצה להצטרף לדיון?
יש להתחבר כדי להגיב.
התחבראין תגובות עדיין. היה הראשון להגיב!