Abstracts

Osteoporosis (OP) is an important complication of long term anti-epileptic treatment in patients with epilepsy. Calcium and vitamin D supplementation have been traditionally used to prevent this condition. Although bisphosphonates are approved for treatment and prevention of OP in post-menopausal women and with men with osteoporosis, there is paucity of evidence measuring the efficacy of this group of medications in men receiving anti-epileptic treatment., Retrospective review of charts of all male subjects with epilepsy at our center identified subjects with OP secondary to chronic antiepileptic therapy. Treatment and response to treatment for men with OP were investigated, specifically by looking at response to bisphosphonates as assessed by DEXA scan. Standard practice in our center is to recommend calcium, vitamin D and exercise for all individuals, regardless of bone density., Seventy three male subjects were screened. Twenty six had Osteopenia and 15 had OP. Nine of the OP subjects received bisphosphonates as a part of their treatment. Of these, 5 (mean age 43.6; range 23-69 years) completed a second DEXA scan by 6/1/06. Calcium, vitamin D and exercise were recommended for all 5 subjects, but only 2/5 could perform moderate exercise. Table 1 demostrates the T scores of OP subjects at baseline, and after treatment with bisphosphonates.[table1]As shown in the table, 80% (4/5) of the subjects had either stabilization or increase in their bone density after being treated with bisphosphonates. Of the 4 responders, only on demonstrated increased bone density., Bisphosphonate therapy appears effective in reducing the progression of osteoporosis in men using antiepileptic medications. Specific patient co-morbidities could contribute to this observation, but it may be important to prevent, screen and treat metabolic bone disease much earlier in men with epilepsy.
This is an on-going study; as more males with OP complete 18 months of bisphosphonate therapy, these results may change.,