Carbamazepine and Lipids in Patients with Epilepsy: Systematic Review and Meta-analysis
Abstract number :
2.234
Submission category :
7. Anti-seizure Medications / 7D. Drug Side Effects
Year :
2021
Submission ID :
1826371
Source :
www.aesnet.org
Presentation date :
12/5/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:53 AM
Authors :
Sihyeong Park, MD - University of Toledo COM LS; Sidra Saleem, MD – Resident PGY-2, Neurology, University of Toledo COM LS; Imran Ali, MD – Professor and Chair, Neurology, University of Toledo COM LS
Rationale: The objective of this study was to review the effect of carbamazepine on lipid profile in patients with epilepsy.
Methods: Systematic review of PubMed and Embase was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement (Figure-1). The primary outcome was increase in total cholesterol low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglyceride were secondary outcomes. Healthy individual or individuals who were taken off carbamazepine served as the control group.
Results: 23 studies with 3,794 (2017+1777) patients were reviewed (Figure 2). In this meta-analysis, 12/23 studies showed association of CBZ with higher level of total cholesterol (TC), whereas 9/23 studies showed no correlation. Overall, there was a significant difference in TC between the CBZ group and control (p-value < 0.0001). In addition, the use of CBZ is also associated with significantly elevated levels of LDL (mean difference=19.75, 95% CI=8.55-30.95, p-value=0.0005), HDL (mean difference=4.03, 95% CI=1.25-6.81, p-value < 0.00001), and triglyceride (mean difference=13.39, 95% CI=4.05-22.73, p-value=0.005). Impact of statin therapy was not available in most of the studies reviewed
Conclusions: This meta-analysis suggests that carbamazepine therapy in patients with epilepsy is associated with elevated lipid levels compared to controls. Use of carbamazepine in patients with epilepsy may increase risk of cardiovascular and cerebrovascular events. This should be taken into consideration in selection of antiseizure medication in patients with epilepsy.
Comparative analysis of carbamazepine with non-enzyme inducing antiseizure medications as well as other newer antiseizure medications are needed to address impact of carbamazepine on vascular risk factors and associated outcomes.
Funding: Please list any funding that was received in support of this abstract.: None.
Anti-seizure Medications