PMID- 24780876
OWN - NLM
STAT- MEDLINE
DCOM- 20150219
LR  - 20181202
IS  - 1873-2763 (Electronic)
IS  - 1873-2763 (Linking)
VI  - 64
DP  - 2014 Jul
TI  - Association between use of antiepileptic drugs and fracture risk: a systematic 
      review and meta-analysis.
PG  - 246-53
LID - S8756-3282(14)00153-7 [pii]
LID - 10.1016/j.bone.2014.04.018 [doi]
AB  - BACKGROUND: It has been shown that antiepileptic drugs (AEDs) may have a 
      detrimental effect on bone health and translate into an increased risk of bone 
      fracture. We aimed to comprehensively evaluate the association between use of 
      AEDs and fracture risk. METHODS: We searched NCBI (PubMed), ISI Web of Science, 
      the Cochrane Library and EMBASE databases for studies reporting fracture risk 
      among users of AEDs. Random-effects meta-analysis was used to pool results across 
      studies. RESULTS: Twenty-two studies met the inclusion criteria. Overall, there 
      was a significant increase in fracture risk among users of AEDs involving 
      1,292,910 participants, with a mean/median age of 36-82 years (relative risk 
      (RR)=1.86; 95% confidence interval (CI) 1.62-2.12). When we limited the studies 
      to those on osteoporosis-related fractures, the RR was still significant. Both 
      liver enzyme-inducing antiepileptic drugs (LEI AEDs) and non-LEI AEDs were 
      associated with an increase in fracture risk, although the estimate for LEI AEDs 
      was higher than that of non-LEI AEDs (RR=1.18; 95% CI 1.11-1.25). For some 
      specific AEDs, use of phenobarbiturate (PB), topiramate (TPM) and phenytoin (PHT) 
      suggested an increase in fracture risk of 78%, 39% and 70%, respectively. 
      CONCLUSIONS: The study suggests a robust association between use of AEDs and 
      fracture risk (particularly for LEI AEDs). It also suggests that several specific 
      AEDs such as PB, TPM and PHT may be associated with an increased risk of 
      fracture.
CI  - Copyright (c) 2014 Elsevier Inc. All rights reserved.
FAU - Shen, Chunhong
AU  - Shen C
AD  - Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang 
      University, Hangzhou 310009, China.
FAU - Chen, Feng
AU  - Chen F
AD  - Department of Neurology, Ningbo Medical Treatment Center Lihuili Hospital, Ningbo 
      315000, China.
FAU - Zhang, Yinxi
AU  - Zhang Y
AD  - Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang 
      University, Hangzhou 310009, China.
FAU - Guo, Yi
AU  - Guo Y
AD  - Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang 
      University, Hangzhou 310009, China.
FAU - Ding, Meiping
AU  - Ding M
AD  - Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang 
      University, Hangzhou 310009, China. Electronic address: 
      dmp_neurology@hotmail.com.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PT  - Systematic Review
DEP - 20140426
PL  - United States
TA  - Bone
JT  - Bone
JID - 8504048
RN  - 0 (Anticonvulsants)
SB  - IM
MH  - Anticonvulsants/*adverse effects
MH  - Fractures, Bone/*chemically induced
MH  - Humans
OTO - NOTNLM
OT  - Antiepileptic drugs
OT  - Fracture risk
OT  - Meta-analysis
EDAT- 2014/05/02 06:00
MHDA- 2015/02/20 06:00
CRDT- 2014/05/01 06:00
PHST- 2013/09/26 00:00 [received]
PHST- 2014/04/11 00:00 [revised]
PHST- 2014/04/17 00:00 [accepted]
PHST- 2014/05/01 06:00 [entrez]
PHST- 2014/05/02 06:00 [pubmed]
PHST- 2015/02/20 06:00 [medline]
AID - S8756-3282(14)00153-7 [pii]
AID - 10.1016/j.bone.2014.04.018 [doi]
PST - ppublish
SO  - Bone. 2014 Jul;64:246-53. doi: 10.1016/j.bone.2014.04.018. Epub 2014 Apr 26.