Efficacy and safety of oxcarbazepine in the treatment of children with epilepsy: a meta-analysis of randomized controlled trials

Abstract

BackgroundTo assess the efficacy and safety of oxcarbazepine (OXC) in the treatment of children with epilepsy.MethodsRandomized controlled trials (RCTs) published in PubMed, Embase, Web of Science, Cochrane Library, Scopus, SinoMed (Chinese BioMedical Literature Service System, China), and Chinese National Knowledge Infrastructure (China) database were systematically reviewed. Eligible studies were those that compared the efficacy and safety of OXC with other antiepileptic drugs in epilepsy. Risk ratio (RR) with 95% confidence intervals (95% CIs) was calculated using fixed-effects or random-effects model.ResultsEleven RCTs with a total of 1,241 patients met the inclusion criteria and were included in this meta-analysis. Compared with other antiepileptic drugs (sodium valproate, levetiracetam, phenytoin, and placebo), OXC was associated with similar seizure-free rate (RR =1.06, 95% CI: 0.94, 1.20; P=0.366) and percentage reduction from baseline in seizure frequency (for ≥75% reduction: RR =1.15, 95% CI: 0.88, 1.49; P=0.310; for 50%–75% reduction: RR =1.12, 95% CI: 0.90, 1.39; P=0.301; for <50% reduction: RR =0.79, 95% CI: 0.56, 1.12; P=0.179). Moreover, patients treated with OXC had a comparable incidence of adverse events compared with those treated with other antiepileptic drugs (RR =1.01, 95% CI: 0.92, 1.11; P=0.760).ConclusionOXC showed similar effects and safety as other antiepileptic drugs in the treatment of children with epilepsy. Further well-conducted, large-scale RCTs are needed to validate these findings.

Levetiracetam Protects Against Cognitive Impairment of Subthreshold Convulsant Discharge Model Rats by Activating Protein Kinase C (PKC)-Growth-Associated Protein 43 (GAP-43)-Calmodulin-Dependent Protein Kinase (CaMK) Signal Transduction Pathway

“…First, we used both VPA and LEV in this study, but VPA seems to be ineffective for cognitive function improvement. In contrast to our findings, a previous study [24] reported that VPA plays an anti-epileptic role by enhancing inhibitory neurotransmitters. Further research is needed on the effects of VPA on cognitive function.…”

“…Sodium valproate (VPA) and levetiracetam (LEV) are extensively used anti-epileptic drugs in clinical practice, and both have satisfactory therapeutic effects and safety [22,23]. VPA plays an anti-epileptic role, mainly by enhancing the inhibitory neurotransmitter gamma aminobutyric acid (GABA) [24], and LEV plays an anti-epileptic role by combining synaptophysin with synaptic vesicle protein 2A (SV2A) [25].…”

Utilization of Antiepileptic Medicines in Swedish Children and Adolescents with Different Diagnoses

“…The Medical Products Agency (MPA) recommends oxcarbazepine to children because of its ‘high evidence in children’ . In meta‐analysis, oxcarbazepine has been shown to be equally efficient as comparative AED with less impact on cognitive function . The increase in levetiracetam could be attributed to its generally better tolerability than conventional AEDs .…”

Levetiracetam for epilepsy: an evidence map of efficacy, safety and economic profiles

“…Thirteen SRs evaluated rates of seizure freedom23,26,31,37,40,41,43–46,49–51 (Figure 2A) and indicated that LEV increased the rates of seizure freedom compared with placebo,23,26,31,40,44,46,49,50 but there was no difference when LEV was compared with OXC,41,49 LTG23,37,45,51 and brivaracetam 40…”