The Effects of Anti-seizure Medications on Lipid Values in Adults Considering Ketogenic Diet Therapy
Abstract number :
2.254
Submission category :
7. Anti-seizure Medications / 7D. Drug Side Effects
Year :
2022
Submission ID :
2203991
Source :
www.aesnet.org
Presentation date :
12/4/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:22 AM
Authors :
Ashley Muller, BS – Johns Hopkins University; Luisa Diaz-Arias, MD – Neurology – Johns Hopkins University; Mackenzie Cervenka, MD – Neurology – Johns Hopkins University; Tanya McDonald, MD, PhD – Neurology – Johns Hopkins University
This abstract has been invited to present during the Broadening Representation Inclusion and Diversity by Growing Equity (BRIDGE) poster session
Rationale: Some anti-seizure medications (ASMs) are known to induce liver enzymes and thereby may impact lipid values including total cholesterol (TC), low density lipoprotein cholesterol (LDL), high density lipoprotein cholesterol (HDL), and triglyceride (TG). Here, we explored the impact of enzyme inducing ASMs (EIASM) on lipid values in adults with epilepsy interested in beginning a high fat ketogenic diet therapy (KDT).
Methods: A total of 228 adults with epilepsy interested in beginning KDT were divided into four groups based on the ASMs they were taking: strong EIASMs, weak EIASMs, non EIASMs, and those on no ASMs. Demographic information (including gender, age, race, weight, physical activity level, history of smoking, hyperlipidemia, and diabetes mellitus), epilepsy-specific clinical history (including epilepsy type (generalized, focal or unknown) and number of ASMs at presentation and previously tried), and lipid values (fasting serum levels of TC, LDL, HDL, and TG) were obtained through retrospective chart review.
Results: There were no statistically significant differences in lipid values between each ASM group. However, there was a significant difference between ASM groups in the frequency of participants with dyslipidemia. There was a significant difference in the frequency of patients with high cholesterol level (TC > 200) among the four ASM groups (χ2(3) = 9.418, p = 0.024). Specifically, the frequency of study participants with elevated cholesterol was higher in the strong EIASM group compared to the non EIASM group (53.3% vs. 28.1%, p < 0.05). There was also a significant difference in the frequency of patients with high LDL level (LDL > 130) among the four ASM groups (χ2(3) = 14.980, p = 0.002). Specifically, the frequency of study participants with elevated LDL levels was higher in the strong EIASM group compared to the non EIASM group (46.7% vs. 18%, p < 0.05). Similarly, the frequency of study participants with elevated LDL levels was higher in the weak EIASM group compared to the non EIASM group (38% vs. 18%, p < 0.05). There were no other statistically significant differences in frequency of high TC, high LDL, high TG, or low HDL levels between ASM groups. We next analyzed the impact of individual ASMs used by more than 15% of the cohort – including levetiracetam, zonisamide, clobazam, lamotrigine, lacosamide, and valproate (VPA) – on lipid levels. There was a significant difference in HDL and TG levels for participants using VPA compared to participants not using VPA (52 (21) vs. 60 (26), H(1) = 9.915, p = 0.002; and 92 (81) vs. 69 (35), H(1) = 9.707, p = 0.002, respectively), but not for LDL or TC levels.
Anti-seizure Medications