Epilepsia. 2022 Sep 8. doi: 10.1111/epi.17407. Online ahead of print.
ABSTRACT
OBJECTIVE: Thyroid hormone abnormalities have been linked to antiseizure medications (ASMs). Oxcarbazepine is considered safer than carbamazepine because it induces the hepatic P-450 metabolic enzymes less than the carbamazepine. However, limited data exist for the influence of oxcarbazepine on thyroid function in children and adolescents. The objective of this study was to determine the effect of oxcarbazepine on thyroid function in these patients.
METHODS: A total of 162 pediatric patients with epilepsy who started oxcarbazepine for the first time between April 2003 and May 2020 were enrolled. The longitudinal effects of oxcarbazepine for thyroid functions were confirmed using general estimating equations.
RESULTS: Serum triiodothyronine (T3), thyroxine (T4), and free thyroxine (fT4) levels significantly decreased during 5 years of follow-up (all P < 0.001). In particular, T3 and fT4 levels were steeply reduced in the first 2 years of oxcarbazepine treatment. There was no significant change in thyroid-stimulating hormone during oxcarbazepine treatment.
SIGNIFICANCE: Serum T3, T4, and fT4 levels significantly decreased during oxcarbazepine use, and this change was maintained during the treatment period. In patients receiving oxcarbazepine, it is recommended that periodic thyroid function testing should be performed, especially within the first two years after starting this ASM. Our results indicate that oxcarbazepine-induced hypothyroidism does not appear to be accompanied by a significant increase in TSH, and consequently might be missed if TSH alone is monitored as a measure of thyroid dysfunction.
PMID:36073252 | DOI:10.1111/epi.17407
