Effect of new antiepileptic drugs on bone metabolism in children:a Meta-analysis

Abstract

Objective \nTo systematically evaluate the effects of new antiepileptic drugs on bone metabolism in children. \n \n \nMethods \nChinese and English databases such as Pubmed, Cochrance Library, China Knowledge Network, Wanfang Knowledge Service Platform, and Weipu Chinese Journal Full-text Database were searched. The search time was limited for each database from the first issue to August 2018, and new anti-epileptic clinical trial of the effects of drugs on bone metabolism in children was selected. The literature was independently read by two reviewers. The effect size was extracted according to the inclusion and exclusion criteria, and the quality of the study was evaluated. The system evaluation (Meta analysis) was performed using Revman 5.3 software. \n \n \nResults \nA total of 526 cases in the experimental group (children taking antiepileptic drugs) and 478 cases in the control group (healthy children or children without taking antiepileptic drugs) were included in 16 pieces of literatures. Meta-analysis showed that there was no significant difference in bone mineral density between experimental group and control group (SMD=- 0.03, 95% CI:- 0.17- 0.10, P=0.62). As for bone turnover markers, there was significant differences in serum total alkaline phosphatase (ALP) between the two groups (SMD=0.19, 95% CI: 0.03- 0.36, P=0.02), while there were no significant differences in serum calcium, serum phosphorus, serum bone specific alkaline phosphatase, serum vitamin D and the ratio of deoxypyridinoline andcreatinine (DPD/Cr). \n \n \nConclusions \nThe new antiepileptic drugs have no effect on bone mineral density. In the aspect of bone turnover markers, the serum total alkaline phosphatase of the children taking the new antiepileptic drugs is higher, but has no effect on other bone turnover markers. \n \n \nKey words: \nMeta analysis;\xa0New antiepileptic drugs;\xa0Bone metabolism