Effects of levetiracetam as a monotherapy on bone mineral density and biochemical markers of bone metabolism in patients with epilepsy

Purpose: Antiepileptic drugs (AEDs) may have adverse effects on bone metabolism and bone mineral density (BMD). The aim of this study is to determine the changes of bone metabolism and BMD in epilepsy patients who are undergoing levetiracetam (LEV) monotherapy. Methods: Drug-naive, sixty-one patients with recent onset epilepsy were recruited (24 female, 37 males; mean age: 31.0 +/- 13.1 years) in this study. We measured calcium, phosphate, bone alkaline phosphatase, parathyroid hormone, osteocalcin, insulin-like growth factor (IGF)-1, C-telopeptide, vitamin D3 levels and bone density measurements with DEXA method before and after LEV administration of mean duration 14.16 +/- 3.36 months. Rusults: T score in lumbar spine (L1-L4) was significantly increased with the correction of multiple T tests using Bonferroni's test across LEV monotherapy (p = 0.0401). However, no significant change was observed in other parameters for BMD and T score. Repeated measures ANOVA with Bonferroni's correction of confounders such as sex, age, and treatment duration revealed significant increase in T score in lumbar spine (p = 0.0164). The level of average LEV dosage itself did not reveal any significant association with BMD and bone metabolism. Conclusions: We suggest that LEV monotherapy may have no harmful effect on bone strength and metabolism for 1 year. (c) 2012 Elsevier B.V. All rights reserved.