Efficacy comparison of oxcarbazepine and levetiracetam monotherapy among patients with newly diagnosed focal epilepsy in China: A multicenter, open‐label, randomized study

Abstract

Aims This multicenter, open‐label, randomized study (Registration No. ChiCTR‐OCH‐14004528) aimed to compare the efficacy and effects of oxcarbazepine (OXC) with levetiracetam (LEV) as monotherapies on patient quality of life and mental health for patients with newly diagnosed focal epilepsy from China. Methods Patients with newly diagnosed focal epilepsy who had experienced 2 or more unprovoked seizures at greater than a 24‐h interval during the previous year were recruited. Participants were randomly assigned to the OXC group or LEV group. Efficacy, safety, quality of life, and mental health were evaluated over 12‐week and 24‐week periods. Results In total, we recruited 271 newly diagnosed patients from 23 centers. Forty‐four patients were excluded before treatment for reasons. The rate of seizure freedom of OXC was significantly superior to that of LEV at 12 weeks and 24 weeks (p < 0.05). The quality of life (except for the seizure worry subsection) and anxiety scale scores also showed significant differences from before to after treatment in the OXC and LEV groups. Conclusions OXC monotherapy may be more effective than LEV monotherapy in patients with newly diagnosed focal epilepsy. Both OXC and LEV could improve the quality of life and anxiety state in adult patients with focal epilepsy.

Levetiracetam versus Oxcarbazepine as monotherapy in newly diagnosed focal epilepsy: A systematic review and meta‐analysis

“…The detailed demographic and study characteristics are shown in Table 1. Two RCTs included in our study were open‐label studies published in 2017 and 2022 (Kim et al., 2017; Zhu et al., 2022). In both trials, enrolled participants were older than 18 years with newly diagnosed focal epilepsy according to the International League against Epilepsy's Classification of Epileptic Seizures (Fisher et al., 2017).…”

“…There were zero fatal cases in both trials due to study medication. Only a few serious AEs were observed in one trial (Kim et al., 2017) while others had no serious AEs (Zhu et al., 2022).…”

“…This finding suggests that for long‐term treatment of newly diagnosed focal epilepsy LEV might be more effective than OXC. In other words, OXC initially has an edge in terms of effectiveness, but notably when used as a long‐term monotherapy for epilepsy, OXC's persistence of efficacy eventually declines in comparison to LEV (Zhu et al., 2022). This could be because OXC is less effective and a greater percentage of patients are discontinuing treatments because of side effects (Li et al., 2020).…”

“…But all these findings were not statistically significant (Kim et al, 2017). While, in contrast, a trial in China found that efficacy in the OXC group had significantly higher number of seizure-free patient at 12 and 24-week than in the LEV group (Zhu et al, 2022). A observational study compared LEV, OXC, and Lamotrigine(LTG) and found that LEV had the greater 1-year seizure-free rate (65.7%) than LTG (60.2%)…”

“…Few studies have compared the safety and efficacy of these drugs as a monotherapy for epilepsy (Kim et al., 2017; Li et al., 2020; Zhu et al., 2022). Thus, we aim to systematically review and perform a meta‐analysis to compare the effectiveness and safety of LEV and OXC in the treatment of newly diagnosed focal epilepsy.…”