Epilepsy Clinical Trial
Official title:
Efficacy Study of Folic Acid Supplementation on Homocysteine Levels in Adolescent Epileptics Taking Antiepileptic Drugs: A Single Blind Randomized Controlled Clinical Trial
The present study is planned to study effect of folic acid supplementation on homocysteine levels and CV risk factors such as BP and lipids in adolescent epileptics taking anti-epileptic drugs (AEDs).
Scientific background, significance and impact value of the project:
Homocysteine is a thiol‑containing amino acid formed as an intermediate product during the
methionine metabolism. Re-methylation pathway recycles Homocysteine back to methionine and
requires vitamin B12 and folic acid as cofactors. [1] The concentration of circulating total
homocysteine is a sensitive marker of inadequate folate and vitamin B12 status. Elevated
homocysteine concentrations are associated with an increased risk for cardiovascular (CV)
disease. [2] The total homocysteine level is the lowest in children and an increase with age
is higher in male sex. [2] The cutoffs for homocysteine level in adolescent range from 4.3
to 9.9 µmol/l, and hyperhomocysteinemia is defined as homocysteine >10.9 µmol/l. [3] Lower
folate and higher homocysteine concentrations may put adolescent on AEDs at special risk for
atherosclerosis in their adulthood. [4] This demands early intervention as Asian Indian
adolescents are genetically more exposed to cadiovascular disease(CVD) risks, AED therapy is
an additional risk for developing future CVDs. Adolescent epileptics on AED have to take it
for long time, and homocysteine elevation itself has got epileptogenic potential and can
cause the risk developing refractory epilepsy. [5] Literature search reveals several studies
depicting role of vitamin B12 in regulation of blood homocysteine levels. [6, 7] However,
the studies confirming role of folic acid supplementation in hyperhomocysteinemia and
related CV diseases are fewer and scarce in AEDs induced hyperhomocysteinemia. Few studies
have reported negative correlation between hyperhomocysteinemia and low folic acid levels in
patients on AEDs. [8] At the same time few studies have reported effectiveness of folic acid
supplementation to normalize the homocysteine levels. [9] Considering the results of various
studies many doctors are now prescribing folic acid along with AEDs, although there is a
scarcity of data from India. In this context, the present study is planned to study effect
of folic acid supplementation on homocysteine levels and CV risk factors such as BP and
lipids in adolescent epileptics taking AEDs.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Prevention
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