META-ANALYSIS OF NEWER ANTI-EPILEPTIC DRUGS FOR TREATMENT OF PARTIAL EPILEPSY IN CHILDREN

Author(s)

Mohd Tahir NA1, Li SC2
1University of Newcastle, Callaghan, NSW, Australia, 2The University of Newcastle, Newcastle, Australia

OBJECTIVES:  The aim of our study was to systematically review the effectiveness and tolerability of newer antiepileptic drugs (AEDs) (i.e lamotrigine, levetiracetam, topiramate, vigabatrin, zonisamide, oxcarbazepine, perampanel, gabapentin, and stiripentol) for treatment of partial epilepsy in children. METHODS:  Articles were systematically retrieved and reviewed from electronic databases and identified bibliographies. The primary outcomes were responder rate, seizure free rate, withdrawal rate and total adverse effects, while the secondary outcomes were specified adverse events of somnolence, nausea and/or vomiting, aggressive behaviour, dizziness, headache, rhinitis and rash. Data analyses were performed using Revman 5.3 to report pooled odd ratio (OR), and heterogeneity test. RESULTS:  14 articles were selected for final review. The pooled OR for responder rate was 2.01 (95% CI: 1.58, 2.56) with low heterogeneity of I of 26% compared to placebo/older AEDs. The pooled OR for seizure free rate, withdrawal rate and total adverse effects was 1.21 (95%CI: 0.64, 2.30), 0.73 (95%CI: 0.48, 1.11) and 1.43 (0.99, 2.06) respectively. The heterogeneity of studies ranges from low for responder rate (I=26%), withdrawal rate (I=31%) and seizure free rate (I=36%) to medium heterogeneity of total adverse events (I=61%). CONCLUSIONS: The use of newer AEDs in the treatment of partial epilepsy in children has small benefits considering the higher responder rate and seizure free rate as well as lower withdrawal event compared to placebo/older AEDs. These results however need be interpreted with caution in view of small number and heterogeneous characteristics of participants as well as short duration of treatment. The data can be used to inform healthcare providers regarding the health benefits of newer AEDs for recommendations and improvement of quality use of medicine of epilepsy care.

Conference/Value in Health Info

2016-10, ISPOR Europe 2016, Vienna, Austria

Value in Health, Vol. 19, No. 7 (November 2016)

Code

PND1

Topic

Clinical Outcomes, Epidemiology & Public Health

Topic Subcategory

Comparative Effectiveness or Efficacy, Safety & Pharmacoepidemiology

Disease

Neurological Disorders

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