Effect of Long-term Carbamazepine Therapy on Bone Health -

Introduction: Recent research reported that prolonged use of AET is associated with changes in bone metabolism, with consequent reduction in bone mineral density (BMD) and increased risk of fractures. Objectives: Therefore, the aim of our study was to investigate the effects of carbamazepine on serum levels of 25 -hydroxyvitamin D and on biomarker of bone formation and resorption (serum levels of osteocalcin). Material and methods: We measured serum levels of 25-OHD and osteocalcin (OCLN) in normal controls (n=30) and in epilepsy patients taking carbamazepine (CBZ) (n=50) in monotherapy for a period of at least twelve months. For each participant, mineral density (BMD) was evaluated by dual-energy X-ray absorptiometry method. Results: The average value of vitamin D in serum was significantly lower in CBZ group than in control group (Vit D 17.03±12.86 vs. 32.03±6.99, p=0.0001). The average value of osteocalcin in serum was significantly higher in CBZ group than in control group (26.06±10.78 vs. 19.64±6, 54, p=0.004).BMD value in CBZ group was significantly lower than in control group (T. score CBZ: 0.08±1.38 vs. T. score control: 0.73± 1.13, p=0.031; Z score CBZ:-0.05±1.17 vs. Z. score control: 0.55±0.79, p=0.015). Conclusion: AEDs are associated with bone disease, as evidenced by biochemical abnormalities and decreased BMD. Patients on long-term antiepileptic therapy, especially with enzyme-inducing agents, could benefit of routine measurement of biochemical markers of bone turnover, and BMD measurement as part of osteoporosis investigation.