P.5.c.003 Association of ABCB1 and SCN1A gene polymorphisms with response to sodium valproate and carbamazepine in Ukrainian patients with epilepsy

This article presents a clinical case of the antiepileptic drug effect on the Vitamin D rate (namely, the patient has been taking Sodium Valproate for a long time) and new data from the foreign publications on this problem. It is known that there is a list of drugs that adversely affect the Vitamin D metabolism. In particular, the drugs reducing the Vitamin D absorption include drugs for the treatment of epilepsy. Antiepileptic drugs are drugs of various origins that are used to prevent or reduce seizures, their corresponding conditions (loss or impairment of consciousness, behavioral and autonomic disorders, etc.), which are observed with recurrent seizures of various forms of epilepsy. The widespread use of these drugs in medical practice requires a detailed study of possible side effects of these drugs and their timely correction, as foreign sources indicate that antiepileptic drugs increase Vitamin D deficiency and worsen the symptoms of proximal myopathy, requiring mandatory medical correction; patients with epilepsy are deficient in vitamin D; сhronic Valproate therapy is associated with lower bone mineral density in young patients with epilepsy. This clinical case showed how a long-term use of Sodium Valproate led to the development of secondary systemic osteoporosis and Vitamin D deficiency, as evidenced by the results of laboratory and instrumental studies, and the discontinued antiepileptic drugs along with Vitamin D supplementation improved the general health of the patient and Vitamin D blood rates. Based on the systemic review and our own observations, it has been concluded that epilepsy patients taking antiepileptic drugs should be given Vitamin D supplements to prevent the development of osteoporosis and Vitamin D deficiency.

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Effects of Sodium Valproate Monotherapy on Blood Liver Enzyme Levels in Patients with Epilepsy: A Meta-Analysis

Hormone and Metabolic Research ◽

10.1055/a-1517-6550 ◽

2021 ◽

Vol 53 (07) ◽

pp. 425-434

Author(s):

Jie Fu ◽

Tao Tao ◽

Zuoxiao Li ◽

Yangmei Chen ◽

Xiu Chen ◽

...

Keyword(s):

Sodium Valproate ◽

Early Stage ◽

Meta Analysis ◽

Group Versus ◽

Cochrane Library ◽

Control Group ◽

China National Knowledge Infrastructure ◽

Asian Patients ◽

Knowledge Infrastructure ◽

Patients With Epilepsy

AbstractWe conducted this meta-analysis to assess the effects of sodium valproate (VPA) monotherapy on blood liver enzymes in patients with epilepsy. PubMed, Web of Science, EBSCO, Cochrane Library, Wanfang, China national knowledge infrastructure databases were searched. Nine studies were included. Results showed: (1) The overall SMD for blood AST, ALT, and GGT levels of VPA monotherapy group versus control group were 0.70 (95% CI=0.31 to 1.09, Z=3.52, p=0.0004), 0.47 (95% CI=− 0.01 to 0.95, Z=1.91, p=0.06), 0.44 (95% CI=0.29 to 0.60, Z=5.55, p<0.00001), respectively. (2) In subgroup meta-analysis, increased blood AST and GGT levels were observed in epileptic minors (AST: total SMD=0.85, 95% CI=0.40 to 1.30, Z=3.69, p=0.0002; GGT: total SMD=0.46, 95% CI=0.29 to 0.63, Z=5.25, p<0.00001). Elevated blood ALT level was observed in Asian patients receiving VPA monotherapy (total SMD=0.70, 95% CI=0.51 to 0.90, Z=7.01, p<0.00001), and the early stage of VPA monotherapy (total SMD=0.93, 95% CI=0.57 to 1.29, Z=5.09, p<0.00001). Overall, our results indicated that blood AST and GGT were significantly increased in epileptic minors receiving VPA monotherapy. The elevation of blood ALT was observed in Asian patients and the early stage of VPA monotherapy. However, due to the small number of included studies, our results should be considered with caution.

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