Vitamin D supplementation for bone health in adults with epilepsy: A systematic review.
Study Goal
The researchers aimed to determine the effect of vitamin D supplementation on bone health in adults with epilepsy, particularly focusing on changes in bone turnover markers and mineralization.
Results Summary
Vitamin D treatment showed positive changes in bone turnover markers, with significant increases in serum calcium (3 of 8 studies), decreases in alkaline phosphatase (6 of 8 studies), and decreases in parathyroid hormone (2 of 4 studies). All 6 studies investigating bone mineralization reported significant findings, though methodologies varied.
Population
Adults (18+ years old) with epilepsy treated with antiepileptic drugs (AEDs).
Effective Dosage
Higher doses (>1800 IU) were suggested for future trials, but specific dosages were not detailed in the abstract.
Duration
Not specified in the abstract.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
antiepileptic drugs (AEDs) | decrease | bone health | - | - | detrimental effect | #1 |
antiepileptic drugs (AEDs) | decrease | serum vitamin D | - | - | reduction | #2 |
vitamin D supplementation | increase | bone turnover markers | persons with epilepsy being treated with AEDs | - | positive changes | #3 |
vitamin D treatment | increase | serum calcium | adults with epilepsy | significant | increase | #4 |
vitamin D treatment | decrease | alkaline phosphatase | adults with epilepsy | significant | decrease | #5 |
vitamin D treatment | decrease | parathyroid hormone | adults with epilepsy | significant | decrease | #6 |
vitamin D | increase | bone mineralization | adults with epilepsy | - | significant findings | #7 |
vitamin D | increase | bone health | adults with epilepsy | - | some benefit | #8 |
OBJECTIVE: Several antiepileptic drugs (AEDs) have been associated with a detrimental effect on bone health through a reduction in serum vitamin D. Subsequently, several studies have investigated the effect of vitamin D supplementation in persons with epilepsy being treated with AEDs. The present systematic review of published literature was conducted to determine the effect of vitamin D intervention on bone health in adults with epilepsy. METHODS: The following databases were searched using keywords including but not limited to epilepsy, bone, and vitamin D: PubMed, Medline, Embase, Scopus, Cochrane Clinical Trials, International Pharmaceutical Abstracts, Health Canada Clinical Trials Database, ClinicalTrials.gov, EU Clinical Trials, and Google. Studies were eligible if there was an epilepsy diagnosis, participants were adults (18+ years old), and vitamin D treatment and bone outcome were provided. Articles were screened independently by 2 reviewers. Methodological quality was assessed using the Cochrane Collaboration's tool and a modified Newcastle Ottawa Scale for nonrandomized studies. RESULTS: Nine studies were found to be eligible for this review. After vitamin D treatment, there appeared to be positive changes in bone turnover markers; 3 of 8 studies found the increase in serum calcium to be significant, 6 of 8 studies found the decrease in alkaline phosphatase to be significant, and 2 of 4 studies found the decrease in parathyroid hormone to be significant. All 6 studies that investigated bone mineralization had significant findings; however, due to varying methodologies, the impact of vitamin D on bone mineralization was inconclusive. SIGNIFICANCE: Vitamin D does appear to have some benefit to bone health in adults with epilepsy, and therefore supplementation could potentially be a requisite to using some AEDs. To clarify the role of vitamin D supplementation to manage the adverse effect of AEDs on bone health in adults with epilepsy, long-term trials that use higher doses (>1800 IU) and measure bone mineral density are necessary.