The Association Between Hyponatremia and Osteoporosis in Patients With Epilepsy.
Study Details
Study Description
Brief Summary
The study investigates the association between normalization of serum sodium levels and bone markers in patients with epilepsy and chronic hyponatremia.
The study is a randomized, single blinded, placebo controlled study where participants will be randomized to either treatment with salt tablets or placebo tablets through 4 months. At the beginning and end of the 4 months bone markers will be measured.
The investigators null-hypothesis is that there will be no difference in bone markers before or after the intervention.
Condition or Disease | Intervention/Treatment | Phase |
---|---|---|
|
N/A |
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
---|---|
Active Comparator: Sodium arm Sodium tablets |
Drug: Sodium chloride
Sodium chloride tablets, 250 mg
|
Placebo Comparator: Placebo arm Placebo tablets |
Drug: Placebo Oral Tablet
Starch tablets
Other Names:
|
Outcome Measures
Primary Outcome Measures
- CTX1 change [At baseline and after 4 months intervention]
bone markers
Secondary Outcome Measures
- P1NP change [At baseline and after 4 months intervention]
Bone markers
- DXA scan change [At baseline and after 4 months intervention]
Density measurements
- Cognitive function change [At baseline and after 4 months intervention]
Epitrack test, scale from 9-49 (9 worst score - 49 best score)
- Life quality change [At baseline and after 4 months intervention]
Quoli 31, scale from 0-100 (0 lowest life quality - 100 best life quality)
- Change in daily pains [At baseline and after 4 months intervention]
VAS from 0-10 (0 no pains - 10 maximum pain)
Eligibility Criteria
Criteria
Inclusion Criteria:
-
Epilepsy requiring treatment for at least 2 years
-
Known hyponatremia (2 subsequent s-sodium values < 136 mmol/l)
-
Age 18-80 years
-
Danish speaking
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Signed form of prior consent
Exclusion Criteria:
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Pregnancy and breastfeeding
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Known osteoporosis. DXA scan < -2.5 T-score. Z-score is used for patients 50 years or younger.
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Undergoing treatment for osteoporosis
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Undergoing treatment with salt tablets
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Known SIADH
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Severe concomitant disease such as cancer or ischemic heart disease
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Alcohol, drug or substance abuse
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
---|---|---|---|---|---|
1 | Rigshospitalet Glostrup | Glostrup | Denmark | 2600 |
Sponsors and Collaborators
- Rigshospitalet, Denmark
Investigators
- Study Chair: Noémi B Andersen, DMSc, MD, Senoir consultant
Study Documents (Full-Text)
None provided.More Information
Publications
- Asconapé JJ. Some common issues in the use of antiepileptic drugs. Semin Neurol. 2002 Mar;22(1):27-39. Review.
- Barsony J, Sugimura Y, Verbalis JG. Osteoclast response to low extracellular sodium and the mechanism of hyponatremia-induced bone loss. J Biol Chem. 2011 Mar 25;286(12):10864-75. doi: 10.1074/jbc.M110.155002. Epub 2010 Dec 6.
- Darbà J, Kaskens L, Pérez-Álvarez N, Palacios S, Neyro JL, Rejas J. Disability-adjusted-life-years losses in postmenopausal women with osteoporosis: a burden of illness study. BMC Public Health. 2015 Apr 2;15:324. doi: 10.1186/s12889-015-1684-7.
- Fedorenko M, Wagner ML, Wu BY. Survey of risk factors for osteoporosis and osteoprotective behaviors among patients with epilepsy. Epilepsy Behav. 2015 Apr;45:217-22. doi: 10.1016/j.yebeh.2015.01.021. Epub 2015 Mar 24.
- Himmerkus N, Sievers B, Bleich M. Carbamazepine affects water and electrolyte homoeostasis in rat--similarities and differences to vasopressin antagonism. Nephrol Dial Transplant. 2012 Oct;27(10):3790-8. doi: 10.1093/ndt/gfs107. Epub 2012 May 4.
- Maraka S, Kennel KA. Bisphosphonates for the prevention and treatment of osteoporosis. BMJ. 2015 Sep 2;351:h3783. doi: 10.1136/bmj.h3783. Review.
- Sejling AS, Pedersen-Bjergaard U, Eiken P. Syndrome of inappropriate ADH secretion and severe osteoporosis. J Clin Endocrinol Metab. 2012 Dec;97(12):4306-10. doi: 10.1210/jc.2012-2031. Epub 2012 Oct 17.
- Sejling AS, Thorsteinsson AL, Pedersen-Bjergaard U, Eiken P. Recovery from SIADH-associated osteoporosis: a case report. J Clin Endocrinol Metab. 2014 Oct;99(10):3527-30. doi: 10.1210/jc.2014-1572. Epub 2014 Jun 27.
- Vasikaran S, Eastell R, Bruyère O, Foldes AJ, Garnero P, Griesmacher A, McClung M, Morris HA, Silverman S, Trenti T, Wahl DA, Cooper C, Kanis JA; IOF-IFCC Bone Marker Standards Working Group. Markers of bone turnover for the prediction of fracture risk and monitoring of osteoporosis treatment: a need for international reference standards. Osteoporos Int. 2011 Feb;22(2):391-420. doi: 10.1007/s00198-010-1501-1. Epub 2010 Dec 24. Review.
- Verbalis JG, Barsony J, Sugimura Y, Tian Y, Adams DJ, Carter EA, Resnick HE. Hyponatremia-induced osteoporosis. J Bone Miner Res. 2010 Mar;25(3):554-63. doi: 10.1359/jbmr.090827.
- Wu FJ, Sheu SY, Lin HC. Osteoporosis is associated with antiepileptic drugs: a population-based study. Epileptic Disord. 2014 Sep;16(3):333-42. doi: 10.1684/epd.2014.0673.
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