The following is a summary of “Independent Associations of Incident Epilepsy and Enzyme-Inducing and Non–Enzyme-Inducing Anti-seizure Medications With the Development of Osteoporosis,” published in the June 2023 issue of Neurology by Josephson, et al.
Researchers conducted a cohort study to quantify osteoporosis risks in incident epilepsy, eiASMs, and non-eiASMs, spanning 1998- 2019, with a median follow-up of 5 years, including 6,275 patients from Clinical Practice Research Datalink and hospital records.
They focused on incident osteoporosis, using appropriate models. Incident epilepsy was considered a time-varying factor. Analyses accounted for various factors, including age, sex, socioeconomic status, corticosteroid use, BMI, surgeries, disorders, smoking, falls, fractures, and screening. Excluding BMI (due to 30% missing data), using propensity score matching for eiASM receipt, and focusing on incident epilepsy in patients aged 65 or more.
The results showed 8,095,441 adults, 6,275 had incident adult-onset epilepsy (51% female, 49% male; incidence rate: 62 per 100,000 person-years; median age: 56 years, IQR 38-73). When controlling for risk factors, epilepsy was associated with a 41% faster time to osteoporosis (TR 0.59, 95% CI 0.52-0.67, P<.001). Both eiASMs (TR 0.91, 95% CI 0.87-0.95, P<.001) and non-eiASMs (TR 0.77, 95% CI 0.76-0.78, P<.001) had increased risks, accounting for 9% and 23% faster times to osteoporosis. Associations remained consistent in propensity score–matched analyses and cohorts restricted to adult-onset or late-onset epilepsy.
They concluded epilepsy increases osteoporosis risk; routine screening and prophylaxis should be considered for all individuals.
Source: jamanetwork.com/journals/jamaneurology/article-abstract/2806001?resultClick=3
