Department of Neurology, University of Health Sciences Umraniye Training and Research Hospital, Istanbul, Turkey.
Clin Neurol Neurosurg. 2022 Jul;218:107270. doi: 10.1016/j.clineuro.2022.107270. Epub 2022 Apr 27.
Levetiracetam (LEV) is an anti-seizure drug (ASD). A consensus has not been reached regarding its effects on bone health. This cross sectional study was planned to assess short, medium and long-term effects on bone density and blood parameters that are associated with bone metabolism.
The sample consisted of 47 patients with epilepsy, who had been on LEV monotherapy for more than six months. All participants were over 18 years of age and had no other risk factors for osteoporosis. None of them used any other anti-seizure drug before. Bone mineral density (BMD) was evaluated with dual energy X-ray absorptiometry (DEXA) and biochemical markers associated with bone health were measured. Patients were divided into three groups depending on how long they had been on LEV for (Group A: <1 year; Group B: 1-5 years, Group C: >5 years) and compared with each other in terms of BMD scores and blood parameters.
The mean age of patients was 32. 6 ± 13.3 and 20 patients were female (42.5%). The mean onset age of epilepsy was 28.1 ± 13.4 years. Average LEV period of consumption was 2.7 ± 2.7 years and mean daily dose was 1041.7 ± 393.9 milligrams. Lumbar BMD scores of the group with LEV usage < 1 year were significantly lower than those of the group with LEV usage of 1-5 years (p < 0.05). Lumbar vertebra scores were found to be lower in group of LEV usage duration of < 1 year when compared with LEV usage duration > 5 years but the difference was not statistically significant.
We argue that LEV might have a negative effect on bone densitometry at the lumbar level in short-time usage for less than one year. Furthermore, no deleterious impact on bone metabolism was observed in long-term treatment. LEV seems as a rational drug for treatment of epilepsy patients, particularly for those with osteoporosis, since the comparative results of one year and longer than 5-years usage data did not show any statistically significant difference.
左乙拉西坦（LEV）是一种抗癫痫药物（ASD）。关于其对骨骼健康的影响尚未达成共识。本横断面研究旨在评估短期、中期和长期对骨密度和与骨代谢相关的血液参数的影响。
该样本由 47 名接受 LEV 单药治疗超过 6 个月的癫痫患者组成。所有参与者年龄均超过 18 岁，且无其他骨质疏松症危险因素。他们之前均未使用过其他抗癫痫药物。采用双能 X 线吸收法（DEXA）评估骨矿物质密度（BMD），并测量与骨健康相关的生化标志物。根据接受 LEV 治疗的时间长短（A 组：<1 年；B 组：1-5 年；C 组：>5 年）将患者分为三组，并比较三组间 BMD 评分和血液参数。
患者的平均年龄为 32.6±13.3 岁，其中 20 名女性（42.5%）。癫痫的平均发病年龄为 28.1±13.4 岁。LEV 的平均使用时间为 2.7±2.7 年，平均日剂量为 1041.7±393.9 毫克。LEV 使用<1 年组的腰椎 BMD 评分明显低于 1-5 年组（p<0.05）。与 LEV 使用>5 年组相比，LEV 使用<1 年组的腰椎骨密度评分较低，但差异无统计学意义。
我们认为，LEV 在使用时间<1 年的短期使用中可能对腰椎骨密度有负面影响。此外，在长期治疗中未观察到对骨代谢的有害影响。LEV 似乎是治疗癫痫患者的合理药物，特别是对骨质疏松症患者，因为 1 年和>5 年使用数据的比较结果没有显示任何统计学上的显著差异。
