Efficacy and Tolerability of Second and Third Generation Anti-epileptic Drugs in Refractory Epilepsy: A Network Meta-Analysis

Efficacy and Tolerability of Second and Third Generation Anti-epileptic Drugs in Refractory Epilepsy: A Network Meta-Analysis

Abstract This study was proposed to compare the relative efficacy and tolerability of the second and third generation AEDs for refractory epilepsy. The 50% responder rate (RR) was selected as the efficacy outcome whereas the incidence of dizziness and somnolence were considered to evaluate the toler...

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Autores principales: Chuanjun Zhuo, Ronghuan Jiang, Gongying Li, Mingjing Shao, Ce Chen, Guangdong Chen, Hongjun Tian, Jie Li, Rong Xue, Deguo Jiang
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Publicado: Nature Portfolio 2017
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Acceso en línea:https://doaj.org/article/47bff92694b1487fb93ee5230ff781d4
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spelling oai:doaj.org-article:47bff92694b1487fb93ee5230ff781d42021-12-02T11:40:14ZEfficacy and Tolerability of Second and Third Generation Anti-epileptic Drugs in Refractory Epilepsy: A Network Meta-Analysis10.1038/s41598-017-02525-22045-2322https://doaj.org/article/47bff92694b1487fb93ee5230ff781d42017-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-02525-2https://doaj.org/toc/2045-2322Abstract This study was proposed to compare the relative efficacy and tolerability of the second and third generation AEDs for refractory epilepsy. The 50% responder rate (RR) was selected as the efficacy outcome whereas the incidence of dizziness and somnolence were considered to evaluate the tolerability of AEDs. Odds ratio (OR) and their 95% credible interval (CrI) were obtained using a consistency model and surface under the cumulative ranking curve (SUCRA) value was calculated to rank AEDs. Topiramate appeared to be significantly more effective than placebo, eslicarbazepine acetate, perampanel, pregabalin, zonisamide, gabapentin and lamotrigine with respect to the 50% RR (all OR > 1). Patients who were managed by eslicarbazepine acetate, perampanel, oxcarbazepine, topiramate and pregabalin were more likely to suffer from dizziness compared to those who receive placebo (all OR > 1). Perampanel, topiramate and pregabalin were related to elevated risks of somnolence compared to placebo (all OR > 1). Moreover, topiramate ranked highest with respect to 50% RR (SUCRA = 0.968) whereas levetiracetam appeared to have balanced efficacy and tolerability (SUCRA = 0.769, 0.743, 0.604 and 0.659). In conclusion, topiramate was the most efficacious AED, while levetiracetam was able to provide patients with balanced efficacy and tolerability.Chuanjun ZhuoRonghuan JiangGongying LiMingjing ShaoCe ChenGuangdong ChenHongjun TianJie LiRong XueDeguo JiangNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 7, Iss 1, Pp 1-12 (2017)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Chuanjun Zhuo
Ronghuan Jiang
Gongying Li
Mingjing Shao
Ce Chen
Guangdong Chen
Hongjun Tian
Jie Li
Rong Xue
Deguo Jiang
Efficacy and Tolerability of Second and Third Generation Anti-epileptic Drugs in Refractory Epilepsy: A Network Meta-Analysis
description Abstract This study was proposed to compare the relative efficacy and tolerability of the second and third generation AEDs for refractory epilepsy. The 50% responder rate (RR) was selected as the efficacy outcome whereas the incidence of dizziness and somnolence were considered to evaluate the tolerability of AEDs. Odds ratio (OR) and their 95% credible interval (CrI) were obtained using a consistency model and surface under the cumulative ranking curve (SUCRA) value was calculated to rank AEDs. Topiramate appeared to be significantly more effective than placebo, eslicarbazepine acetate, perampanel, pregabalin, zonisamide, gabapentin and lamotrigine with respect to the 50% RR (all OR > 1). Patients who were managed by eslicarbazepine acetate, perampanel, oxcarbazepine, topiramate and pregabalin were more likely to suffer from dizziness compared to those who receive placebo (all OR > 1). Perampanel, topiramate and pregabalin were related to elevated risks of somnolence compared to placebo (all OR > 1). Moreover, topiramate ranked highest with respect to 50% RR (SUCRA = 0.968) whereas levetiracetam appeared to have balanced efficacy and tolerability (SUCRA = 0.769, 0.743, 0.604 and 0.659). In conclusion, topiramate was the most efficacious AED, while levetiracetam was able to provide patients with balanced efficacy and tolerability.
format article
author Chuanjun Zhuo
Ronghuan Jiang
Gongying Li
Mingjing Shao
Ce Chen
Guangdong Chen
Hongjun Tian
Jie Li
Rong Xue
Deguo Jiang
author_facet Chuanjun Zhuo
Ronghuan Jiang
Gongying Li
Mingjing Shao
Ce Chen
Guangdong Chen
Hongjun Tian
Jie Li
Rong Xue
Deguo Jiang
author_sort Chuanjun Zhuo
title Efficacy and Tolerability of Second and Third Generation Anti-epileptic Drugs in Refractory Epilepsy: A Network Meta-Analysis
title_short Efficacy and Tolerability of Second and Third Generation Anti-epileptic Drugs in Refractory Epilepsy: A Network Meta-Analysis
title_full Efficacy and Tolerability of Second and Third Generation Anti-epileptic Drugs in Refractory Epilepsy: A Network Meta-Analysis
title_fullStr Efficacy and Tolerability of Second and Third Generation Anti-epileptic Drugs in Refractory Epilepsy: A Network Meta-Analysis
title_full_unstemmed Efficacy and Tolerability of Second and Third Generation Anti-epileptic Drugs in Refractory Epilepsy: A Network Meta-Analysis
title_sort efficacy and tolerability of second and third generation anti-epileptic drugs in refractory epilepsy: a network meta-analysis
publisher Nature Portfolio
publishDate 2017
url https://doaj.org/article/47bff92694b1487fb93ee5230ff781d4
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