Antiepileptic Stiripentol May Influence Bones

Abstract

Bone structure abnormalities are increasingly observed in patients chronically treated with antiepileptic drugs (AEDs). The majority of the available data concern older conventional AEDs, while the amount of information regarding newer AEDs, including stiripentol, is limited. The aim of the study was to assess the effect of stiripentol on bones. For 24 weeks, male Wistar rats, received 0.9% sodium chloride (control group) or stiripentol (200 mg/kg/day) (STP group). In the 16th week of the study, we detected lower serum PINP levels in the STP group compared to the control group. In the 24th week, a statistically significant lower 1,25-dihydroxyvitamin D3 level, higher inorganic phosphate level and higher neutrophil gelatinase-associated lipocalin (NGAL) levels in serum were found in the STP group compared to the control. Micro X-ray computed tomography of the tibias demonstrated lower bone volume fraction, lower trabecular thickness, higher trabecular pattern factor and a higher structure model index in the stiripentol group. Considering the results of this experiment on rats which suggests that long-term administration of stiripentol may impair the cancellous bone microarchitecture, further prospective human studies seem to be justified. However, monitoring plasma vitamin D, calcium, inorganic phosphate and kidney function in patients on long-term stiripentol therapy may be suggested.

Secondary Osteoporosis: A Still Neglected Condition

“…Indeed, stiripentol may induce allosteric changes in the GABAA receptors and modulate GABAergic transmission. Since GABAA and GABAB receptors have been identified in chondrocytes in the growth plate and some data suggest that GABA can regulate the state of the growth plate in an autocrine/paracrine way, it can be hypothesized that the negative effects of stiripentol on bone microarchitecture may be related to its influence on GABA transmission [8]. This study opens up two different research fields.…”