1. Department of Pharmacy, People��s Hospital, Peking University, Beijing 100044, China; 2. Department of Pharmacy, People��s Hospital, Henan Province, Zhengzhou 450003, China; 3. Department of Paediatrics, People��s Hospital, Peking University, Beijing 100044, China
Abstract��OBJECTIVE To systematically review the bone metabolism in the epileptic patients receiving oxcarbazepine monotherapy. METHODS Literatures were searched from Pubmed, EMbase, Cochrane Library, CNKI, VIP, Wanfang and CBM database. The included studies were all cohort studies. The quality of studies was evaluated according to the Newcastle-Ottawa Quality Scale (NOS scale). Meta-analysis was performed by the Cochrane Collaboration��s software RevMan5.3. RESULTS Eleven cohort studies were included, all of which were high quality researches (7-8 according to NOS scale). Compared with the control group, serum calcium and 25-OH-VitD declined in the OXC group (P<0.05). In less than half a year of therapy, the 25-OH-VitD level in the OXC group was lower than the control group (P<0.05), but no statistical difference for the serum calcium (P>0.05). In more than half a year of therapy, the serum calcium level in the OXC group was lower than the control group (P<0.05), but no statistical difference for the 25-OH-VitD (P>0.05). For children in the OXC group, both the serum calcium and 25-OH-VitD were decreased (P<0.05) while there was no statistical difference for adults (P>0.05). Besides, all of the serum phosphorus, parathyroid hormone, osteocalcin were not statistically different between the OXC and control groups (P>0.05). In more than half a year of therapy, parathyroid hormone rose above the control group (P<0.05), while both the therapy duration and age of the therapy subjects had no influence in the remaining indexes. Moreover, there was no statistical difference between the two groups for the bone mineral density in different body parts (P>0.05). CONCLUSION Oxcarbazepine may reduce serum calcium and serum 25-OH-VitD, especially for children. Regardless of age, the serum 25-OH-VitD may decline in less than half a year of therapy, while the serum calcium may decline and parathyroid hormone may increase in more than half a year of therapy. Oxcarbazepine had no significant effect on the serum phosphorus, osteocalcin and bone mineral density. All of the included studies in this article are cohort studies with certain limitations as a result of bias risk.
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