Valproate decreases vitamin D levels in pediatric patients with epilepsy
•Effects of antiepileptic drugs on Vit D levels in pediatric patients were pooled.•Vit D levels decreased in children on long-term valproate monotherapy.•Vit D decrease was also observed after carbamazepine monotherapy. To compare Vitamin D (Vit D) levels in children with epilepsy on valproate monot...
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Published in | Seizure (London, England) Vol. 71; pp. 60 - 65 |
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Main Authors | , , , , , , , , , , |
Format | Journal Article |
Language | English |
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England
Elsevier Ltd
01.10.2019
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Abstract | •Effects of antiepileptic drugs on Vit D levels in pediatric patients were pooled.•Vit D levels decreased in children on long-term valproate monotherapy.•Vit D decrease was also observed after carbamazepine monotherapy.
To compare Vitamin D (Vit D) levels in children with epilepsy on valproate monotherapy with healthy controls.
A meta-analysis performed on articles identified from PubMed and Web of Science online databases evaluated using National Institute of Health National Heart, Lung, and Blood Institute Study Quality Assessment Tools. Subgroup analyses and publication bias assessments were also performed.
Eleven publications were eligible based on inclusion/exclusion criteria for the meta-analysis. Results noted a decrease in the mean Vit D level in children with epilepsy on valproate monotherapy compared with healthy children with a Standard Mean Difference = -0.313 [-0.457, -0.169]. Cumulative meta-analysis showed progressive negative effect of valproate therapy on Vit D levels across time. Other antiepileptic medications caused a similar effect on Vit D status. There was no evidence of publication bias in the analyses. Type of study design and country of origin introduced heterogeneities into the meta-analyses.
This meta-analysis provides evidence that long-term therapy with valproate causes a decrease in Vit D levels in children. Therefore, in children with a seizure disorder on long-term valproate therapy, 25-OH-Vit D levels should be monitored and appropriate supplementation implemented if levels are deficient. |
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AbstractList | To compare Vitamin D (Vit D) levels in children with epilepsy on valproate monotherapy with healthy controls.
A meta-analysis performed on articles identified from PubMed and Web of Science online databases evaluated using National Institute of Health National Heart, Lung, and Blood Institute Study Quality Assessment Tools. Subgroup analyses and publication bias assessments were also performed.
Eleven publications were eligible based on inclusion/exclusion criteria for the meta-analysis. Results noted a decrease in the mean Vit D level in children with epilepsy on valproate monotherapy compared with healthy children with a Standard Mean Difference = -0.313 [-0.457, -0.169]. Cumulative meta-analysis showed progressive negative effect of valproate therapy on Vit D levels across time. Other antiepileptic medications caused a similar effect on Vit D status. There was no evidence of publication bias in the analyses. Type of study design and country of origin introduced heterogeneities into the meta-analyses.
This meta-analysis provides evidence that long-term therapy with valproate causes a decrease in Vit D levels in children. Therefore, in children with a seizure disorder on long-term valproate therapy, 25-OH-Vit D levels should be monitored and appropriate supplementation implemented if levels are deficient. PURPOSETo compare Vitamin D (Vit D) levels in children with epilepsy on valproate monotherapy with healthy controls. METHODSA meta-analysis performed on articles identified from PubMed and Web of Science online databases evaluated using National Institute of Health National Heart, Lung, and Blood Institute Study Quality Assessment Tools. Subgroup analyses and publication bias assessments were also performed. RESULTSEleven publications were eligible based on inclusion/exclusion criteria for the meta-analysis. Results noted a decrease in the mean Vit D level in children with epilepsy on valproate monotherapy compared with healthy children with a Standard Mean Difference = -0.313 [-0.457, -0.169]. Cumulative meta-analysis showed progressive negative effect of valproate therapy on Vit D levels across time. Other antiepileptic medications caused a similar effect on Vit D status. There was no evidence of publication bias in the analyses. Type of study design and country of origin introduced heterogeneities into the meta-analyses. CONCLUSIONThis meta-analysis provides evidence that long-term therapy with valproate causes a decrease in Vit D levels in children. Therefore, in children with a seizure disorder on long-term valproate therapy, 25-OH-Vit D levels should be monitored and appropriate supplementation implemented if levels are deficient. •Effects of antiepileptic drugs on Vit D levels in pediatric patients were pooled.•Vit D levels decreased in children on long-term valproate monotherapy.•Vit D decrease was also observed after carbamazepine monotherapy. To compare Vitamin D (Vit D) levels in children with epilepsy on valproate monotherapy with healthy controls. A meta-analysis performed on articles identified from PubMed and Web of Science online databases evaluated using National Institute of Health National Heart, Lung, and Blood Institute Study Quality Assessment Tools. Subgroup analyses and publication bias assessments were also performed. Eleven publications were eligible based on inclusion/exclusion criteria for the meta-analysis. Results noted a decrease in the mean Vit D level in children with epilepsy on valproate monotherapy compared with healthy children with a Standard Mean Difference = -0.313 [-0.457, -0.169]. Cumulative meta-analysis showed progressive negative effect of valproate therapy on Vit D levels across time. Other antiepileptic medications caused a similar effect on Vit D status. There was no evidence of publication bias in the analyses. Type of study design and country of origin introduced heterogeneities into the meta-analyses. This meta-analysis provides evidence that long-term therapy with valproate causes a decrease in Vit D levels in children. Therefore, in children with a seizure disorder on long-term valproate therapy, 25-OH-Vit D levels should be monitored and appropriate supplementation implemented if levels are deficient. |
Author | Guo, Hongli Li, Guizhou Jing, Xia Sun, Fang Lu, Xiao-Peng Wen, Xiaoyi Xu, Zejun Chen, Feng Hu, Yahui Sun, Jieyu Wang, Tengfei |
Author_xml | – sequence: 1 givenname: Zejun surname: Xu fullname: Xu, Zejun organization: Department of Pharmacy, Children’s Hospital of Nanjing Medical University, Nanjing, China – sequence: 2 givenname: Xia surname: Jing fullname: Jing, Xia organization: Department of Pharmacy, Children’s Hospital of Nanjing Medical University, Nanjing, China – sequence: 3 givenname: Guizhou surname: Li fullname: Li, Guizhou organization: Department of Pharmacy, Children’s Hospital of Nanjing Medical University, Nanjing, China – sequence: 4 givenname: Jieyu surname: Sun fullname: Sun, Jieyu organization: Department of Pharmacy, Children’s Hospital of Nanjing Medical University, Nanjing, China – sequence: 5 givenname: Hongli surname: Guo fullname: Guo, Hongli organization: Department of Pharmacy, Children’s Hospital of Nanjing Medical University, Nanjing, China – sequence: 6 givenname: Yahui surname: Hu fullname: Hu, Yahui organization: Department of Pharmacy, Children’s Hospital of Nanjing Medical University, Nanjing, China – sequence: 7 givenname: Fang surname: Sun fullname: Sun, Fang organization: Department of Pharmacy, Children’s Hospital of Nanjing Medical University, Nanjing, China – sequence: 8 givenname: Xiaoyi surname: Wen fullname: Wen, Xiaoyi organization: Department of Pharmacy, Children’s Hospital of Nanjing Medical University, Nanjing, China – sequence: 9 givenname: Feng surname: Chen fullname: Chen, Feng email: cy.chen508@gmail.com organization: Department of Pharmacy, Children’s Hospital of Nanjing Medical University, Nanjing, China – sequence: 10 givenname: Tengfei surname: Wang fullname: Wang, Tengfei email: twang18@uthsc.edu organization: Department of Pharmacology, University of Tennessee Health Science Center, Memphis, TN, USA – sequence: 11 givenname: Xiao-Peng surname: Lu fullname: Lu, Xiao-Peng organization: Department of Neurology, Children's Hospital of Nanjing Medical University, Nanjing, China |
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Keywords | 25-OH-Vit D Epilepsy Monotherapy Pediatric Carbamazepine Meta-analysis Valproate |
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Snippet | •Effects of antiepileptic drugs on Vit D levels in pediatric patients were pooled.•Vit D levels decreased in children on long-term valproate monotherapy.•Vit D... To compare Vitamin D (Vit D) levels in children with epilepsy on valproate monotherapy with healthy controls. A meta-analysis performed on articles identified... PURPOSETo compare Vitamin D (Vit D) levels in children with epilepsy on valproate monotherapy with healthy controls. METHODSA meta-analysis performed on... |
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SubjectTerms | 25-OH-Vit D Adolescent Anticonvulsants - adverse effects Carbamazepine Carbamazepine - adverse effects Child Child, Preschool Epilepsy Epilepsy - drug therapy Humans Meta-analysis Monotherapy Pediatric Valproate Valproic Acid - adverse effects Vitamin D - blood Vitamin D Deficiency - chemically induced |
Title | Valproate decreases vitamin D levels in pediatric patients with epilepsy |
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