Neurological

Oxcarbazepine associated with a nontraumatic fracture in children 4 to 13 years of age with epilepsy

HealthDay News – For children ages 4 to 13 with epilepsy who start oxcarbazepine but not levetiracetam, anticonvulsant medication (ASM) is associated with an increased risk of non-traumatic fractures, according to a study published in the September issue published by Epilepsia.

Daniel G. Whitney, Ph.D., of the University of Michigan at Ann Arbor, and colleagues extracted damage data for children ages 4 to 13 with at least five years of continuous health insurance. Children with epilepsy who were ASM naive were grouped at baseline, including levetiracetam or oxcarbazepine, and compared with children without epilepsy and without ASM exposure. For a follow-up period of up to four years, the crude incidence rate (IR, per 1,000 person-years) and the IR ratio (IRR) for non-trauma fractures were estimated.

The researchers found that the raw IR for non-trauma fractures was 21.5, 19.8, and 34.4 for non-ASM users without epilepsy who took levetiracetam and oxcarbazepine, respectively. The raw IRR of non-trauma fractures was similar for levetiracetam and non-ASM users (IRR 0.92; 95 percent confidence interval 0.63 to 1.34) and was increased for oxcarbazepine (IRR 1.60; 95 percent Confidence interval 1.09 to 2.35); compared to levetiracetam, the crude IRR for oxcarbazepine was increased (IRR 1.74; 95 percent confidence interval 1.02 to 2.99). After adjusting for covariates, the results were consistent, with the exception of the comparison of oxcarbazepine with levetiracetam (hazard ratio 1.71; 95 percent confidence interval 0.99 to 2.93).

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“Knowing that oxcarbazepine is linked to a higher risk of fractures helps doctors think more about which children to prescribe the drug,” a co-author said in a statement.

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Subjects:

Epilepsy Pediatric Epilepsy Seizure Disorders

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