Effects of levetiracetam on bone mineral density and bone metabolism in patients with epilepsy: A systematic review and meta-analysis.

Xuehui Jiang, Zhiqiang Lin, Xiaowei Huang, Fangfang Xiong, Shuifa Wu, Lei Hong, Zhihang Lin

Journal: Epilepsy & behavior : E&B 2024;158():109925

PMID: 38959743

Full Text on Elsevier Science View on PubMed

Abstract

PURPOSE

The effects of levetiracetam (LEV) on bone mineral density (BMD) and bone metabolism are currently inconclusive, and this study was designed to answer this question.

METHODS

Citations from PubMed, Embase, Cochrane Library, and Web of Science databases (up to February 4, 2024) were reviewed. The effects of LEV on BMD as well as bone metabolism indicators were measured by calculating the standardized mean difference (SMD) with a 95% confidence interval (CI). This study was registered with PROSPERO (CRD42024509560).

RESULTS

A total of 612 individuals from 13 studies were included in the present analysis. Of the items related to bone metabolism, LEV was found to be associated significantly with decreased serum calcium with an SMD of -0.47 (95 % CI, -0.77- -0.16; p = 0.04). However, changes in other markers (including serum phosphorus, 25-hydroxyvitamin D, alkaline phosphatase, and parathyroid hormone) were not statistically significantly correlated with the use of LEV (p > 0.05). Also, when compared to the control groups, the changes in BMD of the observation groups were not significant (p > 0.05).

CONCLUSIONS

The use of LEV may significantly reduce serum calcium in patients with epilepsy, and regular monitoring of bone metabolism-related indicators is recommended.

Address: Department of Pharmacy, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou 362000, China.; Department of Pharmacy, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, China.; Department of Pharmacy, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou 362000, China. Electronic address: [email protected].; Department of Pharmacy, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou 362000, China. Electronic address: [email protected].

DOI: 10.1016/j.yebeh.2024.109925

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MeSH Terms: Levetiracetam, Humans, Bone Density, Epilepsy, Anticonvulsants, Bone and Bones, Calcium