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Effects of zonisamide monotherapy on bone health in drug‐naive epileptic patients
Author(s) -
Koo Dae Lim,
Nam Hyunwoo
Publication year - 2020
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.16678
Subject(s) - medicine , bone remodeling , bone mineral , zonisamide , femoral neck , osteocalcin , endocrinology , n terminal telopeptide , osteoporosis , alkaline phosphatase , epilepsy , biochemistry , chemistry , psychiatry , topiramate , enzyme
Objective Alteration of bone strength is an adverse effect of antiepileptic drug treatment. We investigated the effects of zonisamide (ZNS) monotherapy on bone mineral density (BMD) and biomarkers of bone metabolism after 13 months of treatment in drug‐naive epileptic patients. Methods Fifty‐nine patients with new onset drug‐naive epilepsy were enrolled (29 women, 30 men; mean age = 31.5 ± 11.5 years). The BMD and T scores were measured at the lumbar spine and femoral neck by using dual‐energy X‐ray absorptiometry. Biomarkers specific for bone metabolism (bone‐specific alkaline phosphatase, parathyroid hormone, osteocalcin, insulinlike growth factor‐1, C‐telopeptide, and vitamin D3 levels) were measured before and after long‐term ZNS monotherapy. Analysis of covariance (ANCOVA) was used to estimate BMD and biomarkers of bone metabolism before and after ZNS therapy. Age, sex, treatment duration, and ZNS dosage were included as covariates for adjustment in the ANCOVA model. Furthermore, subgroup analyses were performed for each sex, and the effect size was calculated. Results After 13 months of ZNS treatment, the BMD and T scores at the lumbar spine (L1‐L4 level) and femoral neck were not significantly different. Moreover, the biochemical markers showed no significant differences after ZNS monotherapy. Women showed significantly decreased baseline BMD at the femoral neck compared to men ( P = .026), although the mean age and body mass index were not significantly different between the sexes. No significant changes in BMD or biomarkers of bone metabolism were seen in either sex after 13 months of ZNS treatment. Significance The results suggest that long‐term ZNS monotherapy does not affect bone health in drug‐naive patients with epilepsy negatively.