期刊
SEIZURE-EUROPEAN JOURNAL OF EPILEPSY
卷 22, 期 1, 页码 37-42出版社
W B SAUNDERS CO LTD
DOI: 10.1016/j.seizure.2012.10.002
关键词
Epilepsy; Fractures; Bone; Antiepileptics; Drug toxicity
资金
- UK Medical Research Council
- MHRA
- King's College London Department of Primary Care and Public Health Sciences and Epilepsy Bereaved [1050459]
Purpose: Liver enzyme inducing antiepileptic drugs (LEI AEDs) have adverse effects on bone metabolism but it is unclear whether this translates into increased fracture risk. This population based cohort study aimed to evaluate whether treatment with LEI AEDs is associated with increased risk of fracture in people with active epilepsy. Methods: The cohort included patients diagnosed with epilepsy and prescribed AEDs while registered at a GPRD general practice during 1993-2008. The hazard ratio with current use of LEI AEDs for fracture at any site and hip fracture was estimated using Cox proportional hazards models. Results: There were 7356 fractures (788 hip fractures) in 63 259 participants. In women, the adjusted hazard ratio with use of LEI AEDs was 1.22 for fracture (95% Cl 1.12-1.34; p < 0.001) and 1.49 for hip fracture (1.15-1.94; p = 0.002). In men, the hazard ratio for fracture was 1.09 (0.98-1.20; p = 0.123) and for hip fracture 1.53 (1.10-2.12; p = 0.011). For every 10 000 women treated with LEI AEDs for one year, there could be 48 additional fractures, including 10 additional hip fractures. For every 10 000 men treated with LEI AEDs for one year, there could be 4 additional hip fractures. Conclusions: LEI AEDs may increase the risk of fracture in people with epilepsy. In patients at high risk of osteoporotic fracture alternative AED therapy may be appropriate. Further information is urgently needed on the safety of valproate and newer AEDs and on strategies to maintain bone health in people who need to be treated with LEI. (C) 2012 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据