Antiepileptic Drug Use, Falls, Fractures, and BMD in Postmenopausal Women: Findings From the Women's Health Initiative (WHI)
2010

Antiepileptic Drug Use and Fracture Risk in Postmenopausal Women

Sample size: 138667 publication 10 minutes Evidence: high

Author Information

Author(s): Laura D Carbone, Karen C Johnson, John Robbins, Joseph C Larson, J David Curb, Kathleen Watson, Margery Gass, Andrea Z LaCroix

Primary Institution: Department of Veterans Affairs Medical Center, Memphis, TN, USA

Hypothesis

Compared with nonusers, AED users would have greater loss in BMD, more falls, and more fractures.

Conclusion

Postmenopausal women who use AEDs are at increased risk for fractures, particularly with enzyme-inducing AEDs.

Supporting Evidence

  • Use of AEDs was positively associated with total fractures.
  • Users of more than one AED had a higher risk of fractures.
  • Enzyme-inducing AEDs were associated with the highest fracture risk.
  • Women using AEDs had a higher incidence of falls compared to nonusers.
  • Fracture risk was significant even after adjusting for various covariates.

Takeaway

Women who take certain medications for seizures might fall and break bones more easily, so they need to be careful.

Methodology

A longitudinal cohort study analyzing data from the Women's Health Initiative over an average of 7.7 years.

Potential Biases

Potential confounding factors such as prefracture health and vitamin D levels were not fully controlled.

Limitations

The study did not capture doses of AEDs or seizure history, which may affect fracture risk.

Participant Demographics

138,667 women aged 50 to 79, including 1,385 AED users and 137,282 nonusers.

Statistical Information

P-Value

p ≤ .005 for all significant associations.

Confidence Interval

95% CI 1.30–1.61 for total fractures.

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1359/jbmr.091027

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