Bone Health Screening Practices Among Neurologists in Patients on Antiepileptic Drugs: A Quality Improvement Project

Patel, Archana; An, Sookee; Schomer, Mark; Jülich, Kristina; Elitt, Christopher M.; Heath, Jamie; Putman, Melissa S.; Loddenkemper, Tobias

doi:10.1016/j.pediatrneurol.2019.06.020

Cited by 6 publications

(4 citation statements)

References 26 publications

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“…Nowadays, the treatment of osteoporotic fractures still a di cult point to clinicians, owing to the lower regeneration capacity of imbalanced bone remodeling as compared with the normal bone, as well as lack of Ti-implant speci cally designed for osteoporotic bone even with a hydroxyapatite coating [25][26][27]. In recent years, as people pay attention to drugs that affect bone metabolism, more and more scholars have found that long-term use of antiepileptic drugs has negative effects on bone metabolism and bone mass [28][29][30][31]. In view of the possible effects of antiepileptic drugs on bone regeneration, this study selected clinically commonly used antiepileptic drug valproic acid, using an ovariectomized rat model to observe the effects of these drugs on Ti osseointegration; the results were veri ed our hypothesis that these drugs have a negative effect on osseointegration under osteoporosis.…”

Section: Discussionmentioning

confidence: 99%

Silibinin can enhance the osseointegration of titanium rods in ovariectomized rats maintenance treatment with valproic acid

tao¹

2021

Preprint

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The present work was aimed to evaluate the effect of valproic acid(VPA)，Silibinin (SIM)+VPA on Ti rods osseointegration in ovariectomized rats and further investigation of the possible mechanism. The MC3T3-E1 cells were co-cultured with VPA，SIM +VPA and induced to osteogenesis, and the cell viability，mineralization ability were observed by MTT and ALP staining，Alizarin Red staining and Western blotting. Twelve weeks after bilateral ovariectomy, all animals were randomly divided into four groups: group OVX and VPA，SIM +VPA, and all the rats received Ti implants and animals belong to group VPA，SIM +VPA received valproic acid(300 mg/kg/day), valproic acid(300 mg/kg/day) plus SIM (25mg/kg/day) , respectively, treatment until death at 12 weeks. Micro-CT, histology, biomechanical testing, bone metabolism index and Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) analysis were used to observe the therapeutic effect and explore the possible mechanism. Results shown that VPA decreased new bone formation around the surface of titanium rods and push-out force other than group OVX. Histology, Micro-CT and biochemical analysis results showed combined application of systemic VPA showed harmful effects than OVX group on bone formation in osteopenic rats, with the worse effects on CTX-1, P1NP and microarchitecture as well as biomechanical parameters by down-regulated gene expression of Runx2, OCN, Smad1, BMP-2 and OPG, while up-regulated RANKL. However, after SIM treatment, the above indicators were significantly improved. The present study suggests that systemic use of VPA may bring harm to the stability of titanium implants in osteoporosis, SIM can reverse the negative effect of VPA on the osseointegration of titanium rods in ovariectomized rats.

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Section: Discussionmentioning

confidence: 99%

Silibinin can enhance the osseointegration of titanium rods in ovariectomized rats maintenance treatment with valproic acid

tao¹

2021

Preprint

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“…Intellectual disability 55,56 , leading to severe neurological impairments 57 and immobility 56,58 are shown to be associated with low BMD, as well as a limited sunlight exposure 59 , feeding difficulties and malnutrition 57,60 . Visual impairments, a decreasing physical ability, paretic conditions, impulsiveness, previous falls, incontinence and the non-use of assistive equipment may further increase the risk of falling 61 .…”

Section: Refractory Epilepsy and Intellectual Disabilitymentioning

confidence: 99%

“…Despite substantial numbers of patients on antiseizure medication who have a low BMD, awareness amongst neurologists remains alarmingly low (as studied in highincome countries) [58][59][60][61] . In clinical practice, only 10% to 41% of pediatric neurologists frequently evaluate children on long-term antiseizure medication for bone disease 58,59 .…”

Section: Bone Health Assessmentsmentioning

confidence: 99%

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Osteoporosis and fractures in institutionalized patients with refractory epilepsy and intellectual disability

Berkvens

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Management of antiepileptic drug–induced nutrition-related adverse effects

2020

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Bone Health Screening Practices Among Neurologists in Patients on Antiepileptic Drugs: A Quality Improvement Project

Cited by 6 publications

References 26 publications

Silibinin can enhance the osseointegration of titanium rods in ovariectomized rats maintenance treatment with valproic acid

Silibinin can enhance the osseointegration of titanium rods in ovariectomized rats maintenance treatment with valproic acid

Osteoporosis and fractures in institutionalized patients with refractory epilepsy and intellectual disability

Management of antiepileptic drug–induced nutrition-related adverse effects

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