Oxcarbazepine and Hyponatremia

<i>Background and Objectives:</i> Hyponatremia is one of the most common adverse effects in patients treated with oxcarbazepine (OXC). Different risk factors for OXC-induced hyponatremia have been described as age, female gender, dosage, and combination with other drugs During our clinic...

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Main Authors: Julija Čiauškaitė, Giedrė Gelžinienė, Giedrė Jurkevičienė
Format: Article
Language:English
Published: MDPI AG 2022-04-01
Series:Medicina
Subjects:
Online Access:https://www.mdpi.com/1648-9144/58/5/559
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author Julija Čiauškaitė
Giedrė Gelžinienė
Giedrė Jurkevičienė
author_facet Julija Čiauškaitė
Giedrė Gelžinienė
Giedrė Jurkevičienė
author_sort Julija Čiauškaitė
collection DOAJ
description <i>Background and Objectives:</i> Hyponatremia is one of the most common adverse effects in patients treated with oxcarbazepine (OXC). Different risk factors for OXC-induced hyponatremia have been described as age, female gender, dosage, and combination with other drugs During our clinical practice, we noticed that a longer duration of treatment with OXC could be associated with a higher risk of hyponatremia, therefore, in this study, we aimed to evaluate factors that may increase the risk of OXC-induced hyponatremia. <i>Materials and Methods:</i> Data were retrospectively collected from our clinical database at the Department of Neurology of the Hospital of Lithuanian University of Health Sciences Kaunas Clinics. The sample was divided into three groups: OXC consumers (<i>n</i> = 31), other anti-seizure medications (ASMs) consumers (<i>n</i> = 43), and controls absent ASMs (<i>n</i> = 31). All groups were matched by age and gender. Hyponatremia was defined as <136 mmol/L. <i>Results:</i> The frequency of hyponatremia was significantly higher among OXC patients (61.3%) compared to other ASM patients (5.4%) and controls (3.2%). The mean serum sodium concentration in the OXC group was 133.1 ± 5.1 mmol/L. The frequency of severe hyponatremia among OXC-treated patients was 19.4%; this subgroup was older than patients with moderate hyponatremia and normonatremia and had a longer OXC treatment duration compared to a subgroup of normonatremia. The average duration of OXC therapy was 8.7 ± 5.5 years with a range from 1 to 21 years. Serum sodium concentration and duration of treatment with OXC demonstrated a significant negative correlation (r = −0,427, <i>p</i> = 0.017). Each year of therapy with OXC increased the risk of hyponatremia 1.3 times (OR = 1.326, 95% Cl 1.027–1.712, <i>p</i> = 0.031). Other factors (gender, age, polypharmacy, OXC dosage, and serum concentration) did not show a significant association with the development of hyponatremia. <i>Conclusions:</i> Longer duration of treatment with OXC is an important factor in the development and severity of hyponatremia.
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spelling doaj.art-ac734cdac48c426a8bc9b065e2b3d83b2023-11-23T12:02:27ZengMDPI AGMedicina1010-660X1648-91442022-04-0158555910.3390/medicina58050559Oxcarbazepine and HyponatremiaJulija Čiauškaitė0Giedrė Gelžinienė1Giedrė Jurkevičienė2Department of Neurology, Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus Str. 9, LT 44307 Kaunas, LithuaniaDepartment of Neurology, Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus Str. 9, LT 44307 Kaunas, LithuaniaDepartment of Neurology, Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus Str. 9, LT 44307 Kaunas, Lithuania<i>Background and Objectives:</i> Hyponatremia is one of the most common adverse effects in patients treated with oxcarbazepine (OXC). Different risk factors for OXC-induced hyponatremia have been described as age, female gender, dosage, and combination with other drugs During our clinical practice, we noticed that a longer duration of treatment with OXC could be associated with a higher risk of hyponatremia, therefore, in this study, we aimed to evaluate factors that may increase the risk of OXC-induced hyponatremia. <i>Materials and Methods:</i> Data were retrospectively collected from our clinical database at the Department of Neurology of the Hospital of Lithuanian University of Health Sciences Kaunas Clinics. The sample was divided into three groups: OXC consumers (<i>n</i> = 31), other anti-seizure medications (ASMs) consumers (<i>n</i> = 43), and controls absent ASMs (<i>n</i> = 31). All groups were matched by age and gender. Hyponatremia was defined as <136 mmol/L. <i>Results:</i> The frequency of hyponatremia was significantly higher among OXC patients (61.3%) compared to other ASM patients (5.4%) and controls (3.2%). The mean serum sodium concentration in the OXC group was 133.1 ± 5.1 mmol/L. The frequency of severe hyponatremia among OXC-treated patients was 19.4%; this subgroup was older than patients with moderate hyponatremia and normonatremia and had a longer OXC treatment duration compared to a subgroup of normonatremia. The average duration of OXC therapy was 8.7 ± 5.5 years with a range from 1 to 21 years. Serum sodium concentration and duration of treatment with OXC demonstrated a significant negative correlation (r = −0,427, <i>p</i> = 0.017). Each year of therapy with OXC increased the risk of hyponatremia 1.3 times (OR = 1.326, 95% Cl 1.027–1.712, <i>p</i> = 0.031). Other factors (gender, age, polypharmacy, OXC dosage, and serum concentration) did not show a significant association with the development of hyponatremia. <i>Conclusions:</i> Longer duration of treatment with OXC is an important factor in the development and severity of hyponatremia.https://www.mdpi.com/1648-9144/58/5/559oxcarbazepinehyponatremiaepilepsy
spellingShingle Julija Čiauškaitė
Giedrė Gelžinienė
Giedrė Jurkevičienė
Oxcarbazepine and Hyponatremia
Medicina
oxcarbazepine
hyponatremia
epilepsy
title Oxcarbazepine and Hyponatremia
title_full Oxcarbazepine and Hyponatremia
title_fullStr Oxcarbazepine and Hyponatremia
title_full_unstemmed Oxcarbazepine and Hyponatremia
title_short Oxcarbazepine and Hyponatremia
title_sort oxcarbazepine and hyponatremia
topic oxcarbazepine
hyponatremia
epilepsy
url https://www.mdpi.com/1648-9144/58/5/559
work_keys_str_mv AT julijaciauskaite oxcarbazepineandhyponatremia
AT giedregelziniene oxcarbazepineandhyponatremia
AT giedrejurkeviciene oxcarbazepineandhyponatremia