PURPOSE: Evaluate the clinical comparability of new antiepileptic drugs (AEDs) in partial @entity302 . METHODS: Systematic review of randomized trials (RCTs) comparing a new AED (add-on treatment) with placebo or another AED. PRIMARY OUTCOMES: responder (>= 50% @entity410 reduction) and withdrawal (tolerability) rates. Pooled estimates of odds ratios (ORs) and number needed treat/harm (NNT/ @entity15852 ) taking into account baseline risk were derived by random-effects meta-analysis. Adjusted frequentist indirect comparisons between AEDs were estimated. KEY FINDINGS: Sixty-two placebo-controlled (12,902 @entity1 ) and eight head-to-head RCTs (1,370 @entity1 ) were included. Pooled ORs for responder and withdrawal rates (vs. placebo) were 3.00 [95% confidence interval (CI) 2.63-3.41] and 1.48 (1.30-1.68), respectively. Indirect comparisons of responder rate based on relative measurements of treatment effect (ORs) favored @entity1771 (1.52; 1.06-2.20) in comparison to all other AEDs, whereas @entity2682 (0.67; 0.46-0.97) and @entity13876 (0.66; 0.48-0.92) were less efficacious, without significant heterogeneity. When analyses were based on absolute estimates (NNTs), @entity1771 and @entity4677 were more efficacious, whereas @entity2682 and @entity2810 were less efficacious. Withdrawal rate was higher with @entity2051 (OR 1.60; 1.12-2.29) and @entity1771 (OR 1.68; 1.07-2.63), and lower with @entity2682 (OR 0.65; 0.42-1.00) and @entity4677 (OR 0.62; 0.43-0.89). SIGNIFICANCE: The differences found are of relatively small magnitude to allow a definitive conclusion about which new AED(s) has superior effectiveness. This uncertainty probably reflects the limitations of conclusions based on indirect evidence. The process of pharmacologic clinical decision making in partial @entity302 probably depends more on other aspects, such as individual @entity1 characteristics and pharmacoeconomics, than on available controlled randomized evidence.

Clinical comparability of the new antiepileptic drugs in refractory partial XXXX : a systematic review and meta-analysis.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity410 :: ('MESH:D012640', 'Disease') :: ['seizure'] @entity4677 :: ('MESH:C026098', 'Chemical') :: ['levetiracetam'] @entity2682 :: ('MESH:C040029', 'Chemical') :: ['gabapentin'] @entity2051 :: ('MESH:C036006', 'Chemical') :: ['oxcarbazepine'] @entity1771 :: ('MESH:C052342', 'Chemical') :: ['topiramate'] @entity302 :: ('MESH:D004827', 'Disease') :: ['refractory epilepsy'] @entity13876 :: ('MESH:C403507', 'Chemical') :: ['lacosamide'] @entity15852 :: ('CHEBI:30102', 'Chemical') :: ['NNH'] @entity2810 :: ('MESH:C059205', 'Chemical') :: ['tiagabine']
@entity302 :: (MESH:D004827,Disease) :: ['epilepsy']
