PP14.7 – 2997: Screening osteoporosis in patients with antiepileptic drug using urine N-telopeptide of collagen type I

Abstract

Objective Antiepileptic drug (AED) can affect bone metabolism. But pediatric neurologists ignore the fact because of shorter use of AED in children than in adults. We tried to find out results of reduced bone mineral density (BMD) after use of AED and appropriate screening methods for osteoporosis. Methods This retrospective study was conducted in total 63 patients with epilepsy who visit the Department of Pediatrics of Catholic University Bucheon Saint Mary's Hospital from January 2013 to December 2014. We measure BMD by dual photon absorptiometry and check urine N-telopeptide of collagen type I (NTx) level for bone turnover marker. Results In whole study population, 37 urine NTx level elevated higher than normal range. Among positive urine NTx group, 17 patients had results of reduced BMD after use of AED. Patients with valproic acid (VPA) were 18, oxcarbazepine (OCZ) 28, levetiracetam (LEV) 26, topiramate (TPM) 9 and lamotrigine (LTG) 8. Due to preceding number including multidrug therapy cases, patients with single VPA were 9, single OCZ 19, single LEV 8, single TPM 0 and single LTG 0. Positive urine NTx number of VPA, OCZ, LEV, TPM and LTG group was 9, 21 (P=0.02), 12, 5 and 4 respectively. Positive urine NTx number single VPA, single OCZ and single LEV group was 4, 16 (P=0.01) and 3 respectively. Conclusion Some patient had reduced BMD after use of AED. The incidence of positive urine NTx was significantly different between the patients with OCZ and those with other AEDs in both monotherapy and multitherapy. We suggest using urine NTx for bone turnover marker in pediatric patients with AED.