Some epilepsy and antiseizure medications may be independently associated with an increase in the risk for osteoporosis, according to findings published in JAMA Neurology. Samuel Wiebe, MD, MSc, and colleagues assessed independent hazards for osteoporosis associated with epilepsy and certain enzyme-inducing (eiASMs) and non-enzyme-inducing antiseizure medications (non-eiASMs) from 1998-2019 (median follow- up, 5 years). Of more than 8 million adults, 6,275 had incident adult-onset epilepsy (incidence rate, 62 per 100,000 person-years; median age, 56). When controlling for osteoporosis risk factors, incident epilepsy was independently associated with a 41% faster time to incident osteoporosis (P<0.001). Both eiASMs (P<0.001) and non-eiASMs (P<0.001) were also associated with significant increased risks regardless of epilepsy. The independent associations among epilepsy, eiASMs, and non-eiASMs remained consistent across multiple adjusted analyses, including for late-onset epilepsy. “Routine [osteoporosis] screening and prophylaxis should be considered in all people with epilepsy,” Dr. Wiebe and colleagues wrote.
