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Vitamin D supplementation for bone health in adults with epilepsy: A systematic review
Author(s) -
Fernandez Haya,
Mohammed Heba Tallah,
Patel Tejal
Publication year - 2018
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/epi.14015
Subject(s) - vitamin d and neurology , medicine , epilepsy , bone remodeling , clinical trial , bone health , meta analysis , parathyroid hormone , vitamin d deficiency , pediatrics , osteoporosis , bone mineral , psychiatry , calcium
Summary Objective Several antiepileptic drugs ( AED s) have been associated with a detrimental effect on bone health through a reduction in serum vitamin D. Subsequently, several studies have investigated the effect of vitamin D supplementation in persons with epilepsy being treated with AED s. The present systematic review of published literature was conducted to determine the effect of vitamin D intervention on bone health in adults with epilepsy. Methods The following databases were searched using keywords including but not limited to epilepsy, bone, and vitamin D: PubMed, Medline, Embase, Scopus, Cochrane Clinical Trials, International Pharmaceutical Abstracts, Health Canada Clinical Trials Database, ClinicalTrials.gov, EU Clinical Trials, and Google. Studies were eligible if there was an epilepsy diagnosis, participants were adults (18+ years old), and vitamin D treatment and bone outcome were provided. Articles were screened independently by 2 reviewers. Methodological quality was assessed using the Cochrane Collaboration's tool and a modified Newcastle Ottawa Scale for nonrandomized studies. Results Nine studies were found to be eligible for this review. After vitamin D treatment, there appeared to be positive changes in bone turnover markers; 3 of 8 studies found the increase in serum calcium to be significant, 6 of 8 studies found the decrease in alkaline phosphatase to be significant, and 2 of 4 studies found the decrease in parathyroid hormone to be significant. All 6 studies that investigated bone mineralization had significant findings; however, due to varying methodologies, the impact of vitamin D on bone mineralization was inconclusive. Significance Vitamin D does appear to have some benefit to bone health in adults with epilepsy, and therefore supplementation could potentially be a requisite to using some AED s. To clarify the role of vitamin D supplementation to manage the adverse effect of AED s on bone health in adults with epilepsy, long‐term trials that use higher doses (>1800 IU) and measure bone mineral density are necessary.