Clinical

Valproate linked with increased risk of nonalcoholic liver disease

Last Updated: 2004-05-26 13:13:22 -0400 (Reuters Health)

NEW YORK (Reuters Health) - The results of a small study confirm previous findings showing increases in body weight resulting from valproate therapy. The results also show that patients treated with VPA appear to have an increased risk of developing nonalcoholic fatty liver disease (NAFLD).

"Nonalcoholic fatty liver disease was defined recently as another symptom of insulin resistance," Dr. Gerhard J. Luef and colleagues from Innsbruck University Hospital, Austria, report in the May issue of the Annals of Neurology. "Continuous therapy with valproate can result in increased body weight and insulin resistance, but no data are yet available on a possible relationship between valproate and nonalcoholic fatty liver disease."

To investigate, the team recruited 45 nondiabetic patients who presented with focal or generalized epilepsy and were receiving treatment with either carbamazepine or valproate monotherapy.

Characteristics of fatty liver disease were observed on ultrasound in 14 of the 23 valproate-treated patients and in 5 of the 22 carbamazepine-treated patients. Nine patients and 17 patients in the valproate and carbamazepine groups, respectively, were free of steatosis. Patients in the valproate group had higher levels of steatosis that those in the carbamazepine group.

"In both treatment groups, patients with steatosis had a higher BMI than did those without, and the ultrasound finding of steatosis showed a significant positive correlation with BMI in the overall study population (p < 0.001) as well as in the valproate-treated (p < 0.003) and carbamazepine -treated (p < 0.001) patients," Dr. Luef and colleagues note.

Based on these findings, "the risk of developing NALFD...appears to be increased in patients treated with valproate," the researchers conclude.

Ann Neurol 2004;55:729-732.