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Falls and fractures in patients chronically treated with antiepileptic drugs.

Abstract

OBJECTIVE
To evaluate fractures and falls in epilepsy patients taking antiepileptic drugs (AED) and to assess their awareness of AED-related bone health, falls, and fracture risk.
METHODS
A cross-sectional study was conducted in epilepsy patients taking AEDs and in nonepileptic non-AED users. Information on falls and fracture history was collected.
RESULTS
A total of 150 AED users were compared with 506 non-AED users. Users had greater odds of fracture at spine (odds ratio [OR] 3.92; confidence interval [CI] 1.08-14.16; p = 0.037), clavicle (OR 3.75; CI 1.24-11.34; p = 0.019), and ankle sites (OR 2.34; CI 1.01-5.42; p = 0.048), increased odds for osteoporosis (OR 4.62; CI 1.40-15.30; p = 0.012), and fracture occasions (OR 2.64; CI 1.29-5.43; p = 0.008). We estimate that with every year of AED use the odds of fractures increase by 4%-6%, or 40% per decade for any fracture (OR 1.40; CI 1.02-1.91) and 60% for seizure-related fractures (OR 1.63; CI 1.10-2.37). Non-seizure-related fractures (69% of cumulative fractures) occurred more than seizure-related fractures during therapy. Female users, compared to female nonusers, had more non-seizure falls (31% vs 17%, p = 0.027) and multiple falls (18% vs 5%, p = 0.028) in the preceding year. Fewer than 30% of epilepsy patients knew of the association of AED use with increased risk for fractures, decreased bone mineral density, or falls.
CONCLUSIONS
Epilepsy patients taking AEDs had a higher risk of fractures, which was highest in those with longer-term AED exposure. Female AED users had a higher prevalence of falls than matched nonusers. Awareness among epilepsy patients regarding risks of falling and fractures was low.

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    • Authors

    Shiek Ahmad B, Hill KD, O'Brien TJ, Gorelik A, Habib N, Wark JD

    Institution

    Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria.

    Source

    Neurology 79:2 2012 Jul 10 pg 145-51

    MeSH

    Accidental Falls
    Adult
    Aged
    Anticonvulsants
    Bone Density
    Cross-Sectional Studies
    Female
    Fractures, Bone
    Humans
    Male
    Middle Aged
    Odds Ratio
    Osteoporosis
    Risk
    Seizures

    Pub Type(s)

    Comparative Study
    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    22700806