The effects of oxcarbazepine and valproate therapies on growth in children with epilepsy

Endocr Res. 2012;37(4):163-74. doi: 10.3109/07435800.2012.662663. Epub 2012 May 25.

Abstract

Aim: This study aimed to evaluate the effects of monotherapy with valproate or oxcarbazepine on the linear growth of children with idiopathic epilepsy.

Methods: Antiepileptic treatment with valproate or oxcarbazepine was initiated in 76 patients. These were evaluated at baseline and at 6 and 18 months after commencement of therapy to determine height standard deviations (height z-scores). Serum ghrelin, insulin-like growth factor-1, and insulin-like growth factor-binding protein-3 levels were measured.

Results: In prepubertal patients receiving oxcarbazepine, height z-scores were elevated after 6 and 18 months of therapy (p = 0.008 and p = 0.001, respectively); in pubertal patients, a significant increase was noted at the 18th month of therapy (p = 0.004). In prepubertal patients receiving oxcarbazepine, serum standardized insulin-like growth factor-1 and insulin-like growth factor-binding protein-3 levels were significantly higher at the 18th month of therapy compared with baseline (p = 0.005 and p = 0.004, respectively). In puber-tal patients receiving valproate, serum ghrelin levels were significantly decreased at the 18th month of therapy compared with baseline (p = 0.006).

Conclusion: Exposure to oxcarbazepine stimulated linear growth in epileptic patients through mechanisms involving the release of insulin-like growth factor-1 and insulin-like growth factor-binding protein-3. In contrast, expo-sure to valproate did not affect linear growth, but did lead to a decrease in serum ghrelin levels.

Publication types

  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anticonvulsants / therapeutic use*
  • Body Height / drug effects*
  • Carbamazepine / analogs & derivatives*
  • Carbamazepine / therapeutic use
  • Child
  • Child, Preschool
  • Epilepsy / drug therapy*
  • Female
  • Ghrelin / blood
  • Humans
  • Insulin-Like Growth Factor Binding Protein 3 / blood
  • Insulin-Like Growth Factor I / analysis
  • Male
  • Oxcarbazepine
  • Puberty / blood
  • Puberty / drug effects*
  • Valproic Acid / therapeutic use*

Substances

  • Anticonvulsants
  • Ghrelin
  • IGFBP3 protein, human
  • Insulin-Like Growth Factor Binding Protein 3
  • Carbamazepine
  • Valproic Acid
  • Insulin-Like Growth Factor I
  • Oxcarbazepine