Enzyme-inducing antiseizure drugs associate with low bone mineral density in men with epilepsy

Little is known about the impact of enzyme-inducing antiseizure drugs (EI-ASD) on the reduction of Bone Mineral Density (BMD) in men with epilepsy (MWE). Objectives: To evaluate the BMD in MWE exposed to EI-ASDs (phenytoin, carbamazepine and phenobarbital) and its relationship with the duration of epilepsy. Methods: We evaluated BMD from 74 consecutive MWE (median age (range), 52.5 (25- 74) years) exposed to previous or current EI-ASDs, followed at UNICAMP-Brazil. Individuals were split into two groups (young-group, 31 individuals [25-49 years]; older group, 43 subjects, [50-74 years]). The BMD test evaluated t-score indexes from the femoral neck, whole femur and lumbar spine. Osteopenia was defined with t-score of - 1.0 to -2.4; osteoporosis, with T-scores lower than -2.5. Data were extracted from medical records. We analyzed data with SPSS22, performed chi-square tests for categorical variables and applied a partial correlation test (controlled for age) between BD scores and duration of epilepsy. Results: BMD was reduced in 49/74 men (66.2%). Both groups presented equivalent proportions of BMD abnormalities (p=0.087) (young-group [14/41 normal (45%), 12/31 osteopenia (39%), 5/31 osteoporosis (16%)]; older-group [11/43 normal (26%), 16/43 osteopenia (37%), 16/43 osteoporosis (37%)]. BMD did not correlate with the duration of disease or age of onset. Conclusion: BMD reduction is highly prevalent in MWE exposed to EI-ASD, including young individuals. Data suggest that exposure to EI-ASD may associate with early BMD reduction, which evolve to osteopenia and osteoporosis. BMD evaluation in MWE and appropriate treatment may be necessary to reduce fractures’ risk.