Abstracts

Rationale: Epilepsy affects 50 million people world-wide. A large proportion of these patients are treated with antiepiletic drugs (AED) for management of their condition and for long-term. The effects of such treatment on plasma lipids levels are unclear. In order to characterize the association between commonly used AEDs and plasma lipid levels in patients with epilepsy, we performed a systematic review of the literature. Methods: We sought observational studies that reported association between plasma lipid levels in patients with epilepsy on treatment with AED. The outcomes of interests were plasma LDL, HDL, apolipoprotein, cholesterol and triglyceride levels. AED could include phenobarbitone, phenytoin, carbamazepine, valproic acid, lamotrigine, gabapentin, vigabatrin or topiramate. The control population could include healthy controls, pre-treatment patients or patients on other AEDs listed but not limited to the list. We applied no limitations by region of study or study type. We conducted a systematic search of the following bibliographic databases from their inception until June 1, 2014: Medline including Pre-Medline, EMBASE, ProQuest Dissertations and Theses, Scirus and Web of Science. We used free texts and database specific subject headings to develop database specific search strategies with help of a health information specialist. Two reviewers screened citations and rated articles independently for inclusion; disagreements were resolved by consultation with the third reviewer. Once the pertinent studies are included in the study a pre-set data abstraction form will be used for extracting the information of interest. The studies will be assessed for their quality using the Downs and Black scale for observational studies. Due to the anticipated heterogeneity, meta-analyses will not be conducted. Results: A total of 12239 titles were found from the initial search strategy across all databases following de-duplication. Of these 94 studies are included for full text review. The adjudication process is underway and the reviewers are sifting through these studies to select the studies that will be included in the final review. Conclusions: Dyslipidemia is associated with increased risk of vascular events, including stroke. The systematic review will be the most comprehensive review of the literature studying the association of AEDs and dyslipidemia. The goal is to provide health professional with the information necessary to make informed decision regarding the selection of AED treatment especially for long-term use given the excess risk of vascular events with dyslipidemia.