Effect of antiepileptic drug monotherapy on endogenous sex hormonal profile in men and women with epilepsy.

IF 2.3 3区 医学 Q2 BEHAVIORAL SCIENCES Epilepsy & Behavior Pub Date : 2024-12-17 DOI:10.1016/j.yebeh.2024.110220
Neha Kanojia, Debleena Guin, Nitin Machahary, Sarita Thakran, Samiksha Kukal, Jyotika Thakur, Biswajit Panda, Priyanka Singh, Ankit Srivastava, Pooja Singh, Sandeep Grover, Anju Singh, Viren Sardana, Luciano Saso, Shrikant Kukreti, Ritushree Kukreti
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Abstract

Objective: To assess the alterations of endogenous sex hormone profiles in patients with epilepsy (PWE) on different antiepileptic drug (AED) monotherapies compared to healthy controls and drug naïve PWE (DNPWE).

Methods: Four databases MEDLINE, EMBASE, SCOPUS, and CENTRAL were searched for analytical observational/intervention studies on the assessment of endogenous sex hormones in PWE compared to healthy controls and DNPWE. Two researchers reviewed the title/abstract, and full-text articles for the selection of the studies independently. Extracted data included information on study details, participant demographics, interventions, method of assessment and study results. The study outcomes were used to calculate the standard mean differences (SMD) and 95% confidence interval (CI) as effect size for assessing differences in the endogenous sex hormone levels between the treatment group and control/DNPWE.

Results: Among 5888 publications retrieved, 33 studies were included. Enzyme-inducing AEDs (EIAEDs) such as phenytoin (men: SMD = 1.36; 95%CI = 1.06,1.66) and carbamazepine (men: SMD = 0.71; 95%CI = 0.39, 1.04 and women: SMD = 0.54; 95%CI = 0.25, 0.83) and weak-EIAED oxcarbazepine (men: SMD = 0.62; 95%CI = 0.26,0.99) increased the SHBG levels in PWE compared to control. The same trend was observed when comparing it to DNPWE. No significant changes in SHBG were observed for non-EIAEDs valproic acid, lamotrigine and levetiracetam in men. Lamotrigine significantly reduced SHBG in women (SMD = -0.50; 95%CI = -0.85, -0.16) compared to controls. Testosterone (T) levels were significantly reduced for both carbamazepine (SMD = -0.39; 95%CI = -0.67, -0.11) and valproic acid (SMD = -0.48; 95%CI = -0.74, -0.21) treated men compared to control.

Significance: Our findings emphasize the importance of screening the endogenous sex hormonal profile in PWE on AED monotherapies to evaluate the associated endocrine-related perturbations which may impact reproductive functions.

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抗癫痫药物单药治疗对男女癫痫患者内源性性激素谱的影响。
目的:评价不同抗癫痫药物(AED)单药治疗的癫痫(PWE)患者内源性性激素谱与健康对照和naïve PWE (DNPWE)药物的变化。方法:检索MEDLINE、EMBASE、SCOPUS和CENTRAL四个数据库,检索PWE与健康对照组和DNPWE比较内源性性激素评估的分析性观察/干预研究。两名研究人员独立审查了标题/摘要和全文文章,以选择研究。提取的数据包括研究细节、参与者人口统计、干预措施、评估方法和研究结果等信息。研究结果用于计算标准平均差异(SMD)和95%置信区间(CI)作为评估治疗组与对照组/DNPWE之间内源性性激素水平差异的效应量。结果:在5888篇文献中,共纳入33篇研究。酶诱导抗癫痫药(EIAEDs),如苯妥英(男性:SMD = 1.36;95%CI = 1.06,1.66)和卡马西平(男性:SMD = 0.71;95%CI = 0.39, 1.04,女性:SMD = 0.54;95%CI = 0.25, 0.83)和弱eiaed奥卡西平(男性:SMD = 0.62;95%CI = 0.26,0.99)与对照组相比,PWE组SHBG水平升高。将其与DNPWE进行比较时也观察到相同的趋势。非eied药物丙戊酸、拉莫三嗪和左乙拉西坦对男性SHBG无显著影响。拉莫三嗪显著降低女性SHBG (SMD = -0.50;95%CI = -0.85, -0.16)。卡马西平组睾酮(T)水平显著降低(SMD = -0.39;95% ci = -0.67, -0.11)和丙戊酸(SMD = -0.48;95%CI = -0.74, -0.21)。意义:我们的研究结果强调了在AED单药治疗中筛选PWE内源性性激素谱的重要性,以评估可能影响生殖功能的相关内分泌相关扰动。
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来源期刊
Epilepsy & Behavior
Epilepsy & Behavior 医学-行为科学
CiteScore
5.40
自引率
15.40%
发文量
385
审稿时长
43 days
期刊介绍: Epilepsy & Behavior is the fastest-growing international journal uniquely devoted to the rapid dissemination of the most current information available on the behavioral aspects of seizures and epilepsy. Epilepsy & Behavior presents original peer-reviewed articles based on laboratory and clinical research. Topics are drawn from a variety of fields, including clinical neurology, neurosurgery, neuropsychiatry, neuropsychology, neurophysiology, neuropharmacology, and neuroimaging. From September 2012 Epilepsy & Behavior stopped accepting Case Reports for publication in the journal. From this date authors who submit to Epilepsy & Behavior will be offered a transfer or asked to resubmit their Case Reports to its new sister journal, Epilepsy & Behavior Case Reports.
期刊最新文献
A computer-assisted rehabilitation program improves self-management, cognition, and quality of life in epilepsy: A randomized controlled trial. Caregiving burden for adults with epilepsy and coping strategies, a systematic review. Cognitive and behavioral impact of antiseizure medications, neuromodulation, ketogenic diet, and surgery in lennox-gastaut syndrome: A comprehensive review. Incidence of RINCH in pediatric EMU patients. The attitude of medical students, resident doctors, and nurses toward people with epilepsy: A multi-centre study.
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