Τομέας Υγείας - Μητέρας - ΠαιδιούLibrary of the School of Health Sciences
Παπαευαγγέλου Βασιλική,Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Παπαδημητρίου Αναστάσιος, Καθηγητής, Ιατρική Σχολή,ΕΚΠΑ
Ντινόπουλος Αργύριος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Πρίφτης Κωνσταντίνος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Πέππα Μελπομένη, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Αττιλάκος Αχιλλέας, Επίκουρος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Βάρτζελης Γεώργιος, Επίκουρος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Μελέτη παραγόντων κινδύνου για καρδιαγγειακή νόσο σε παιδιά με επιληψία που βρίσκονται σε μακροχρόνια αγωγή με λεβετιρασετάμη.
Effect of levetiracetam monotherapy on cardiovascular risk factors in children with epilepsy.
Τhe purpose of the study was to investigate prospectively the short and long-term effect of levetiracetam monotherapy on serum lipids levels, serum total homocysteine and thyroid gland function in epileptic children and whether it increases their cardiovascular risk.
Material and methods: We studied 32 epileptic children (18 females and 14 males), with mean age 5,94 ± 4,1 years, treated for new onset epilepsy with levetiracetam monotherapy. Apart from epilepsy, all patients had normal growth, normal liver and renal function and absence of any other medication or prior antiepileptic medication.
Serum total cholesterol (TC), High-density lipoprotein cholesterol (HDL-C), Low-density lipoprotein cholesterol (LDL-C), Triglycerides (TGs), Apolipoprotein A-I (apo A-I), Apolipoprotein B (apo B), Lipoprotein (a) [Lp(a)], Free thyroxine (FT4), Thyrotropin (TSH), Folate (s-F), Vitamin B-12 (s-B12) and serum total homocysteine, were evaluated before, at 2, 6 and 12 months of levetiracetam monotherapy. We also obtained full blood count and biochemical markers.
Dropouts due to the need for other antiepileptic treatment and missing data reduced the initial sample size to 25 patients at 6 months and 20 patients at 12 months of levetiracetam treatment.
Results: TGs and TGs/HDL-C ratio were significantly decreased at 6 (p=0.030 and p=0.027, respectively) and 12 months (p=0.001 and p=0.003, respectively) of levetiracetam treatment. LDL-C/HDL-C ratio was significantly decreased at 12 months of levetiracetam treatment.
Serum total homocysteine was significantly decreased at 2 months of treatment (p=0.031), while no significant alterations where detected in the vitamin B12 or folic acid level during the study period. Thyroid hormones showed no alterations during the study period.
We also found that lymphocyte count was significantly decreased at 6 and 12 months of LEV treatment (p=0.019, p=0.003 respectively). Four children at 6 months of age and three children at 12 months of treatment had lymphocyte count below 10th percentile for age.
Μoreover, we found significant reduction in uric acid concentration at 6 months after levetiracetam initiation (p=0.02), and increased alkalıne phosphatase level after 2 and 6 months of levetiraceram treatment (p=0.005, p=0.007 respectively). Both alterations seem to
be transient. No other significant alterations where noted in the other parameters evaluated during the study period.
Conclusions: Levetiracetam does not cause adverse alterations on blood lipids, homocysteine or thyroid hormones and does not increase the long-term cardiovascular risk for epileptic children taking levetiracetam. Τherefore, levetiracetam may be considered as a safer alternative drug for the prevention or antiepileptic drug-induced cardiovascular complications in adult life.
Main subject category:
Levetiracetam, Thyroid, Lipids, Homocysteine, Cardiovascular risk.
Number of references:
Paschalidou Maria PhD.pdf
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