PMID- 26695884
OWN - NLM
STAT- MEDLINE
DCOM- 20160428
LR  - 20181221
IS  - 1469-493X (Electronic)
IS  - 1361-6137 (Linking)
IP  - 12
DP  - 2015 Dec 23
TI  - Topiramate monotherapy for juvenile myoclonic epilepsy.
PG  - CD010008
LID - 10.1002/14651858.CD010008.pub2 [doi]
AB  - BACKGROUND: Topiramate is a newer broad-spectrum of antiepileptic drug (AED). 
      Some studies have shown the benefits of topiramate monotherapy in the treatment 
      of juvenile myoclonic epilepsy (JME). However, there are no current systematic 
      reviews to determine the efficacy and tolerability of topiramate monotherapy in 
      people with JME. OBJECTIVES: To determine the efficacy and tolerability of 
      topiramate monotherapy in the treatment of JME. SEARCH METHODS: We searched the 
      Cochrane Epilepsy Group Specialized Register (2 November 2015), the Cochrane 
      Central Register of Controlled Trials (CENTRAL via the Cochrane Register of 
      Studies CRSO, 2 November 2015), MEDLINE (Ovid, 2 November 2015), EMBASE (1 July 
      2015) and ClinicalTrials.gov (2 November 2015). In an effort to identify further 
      published, unpublished and ongoing trials, we searched ongoing trials registers, 
      reference lists and relevant conference proceedings, and contacted authors and 
      pharmaceutical companies. SELECTION CRITERIA: We included randomized controlled 
      trials (RCTs) investigating topiramate monotherapy versus placebo or other AED 
      treatment for people with JME, with the outcomes of proportion of responders or 
      experiencing adverse events (AEs). DATA COLLECTION AND ANALYSIS: Two review 
      authors independently screened the titles and abstracts of identified records, 
      selected studies for inclusion, extracted data, cross-checked the data for 
      accuracy and assessed the methodological quality. We performed no meta-analyses 
      due to the limited available data. MAIN RESULTS: We included three studies with 
      83 participants. For the efficacy, a greater proportion of participants in the 
      topiramate group had a 50% or more reduction in primarily generalized 
      tonic-clonic seizures (PGTCS) compared with participants in the placebo group. 
      There were no significant differences between topiramate versus valproate in 
      participants responding with a 50% or more reduction in myoclonic seizures or in 
      PGTCS or seizure-free. Concerning tolerability, we ranked AEDs associated with 
      topiramate as moderate-to-severe, while we ranked 59% of AEDs linked to valproate 
      as severe complaints. Moreover, systemic toxicity scores were higher in the 
      valproate group than the topiramate group. We judged the quality of the evidence 
      from the studies to be very low. AUTHORS' CONCLUSIONS: This review does not 
      provide sufficient evidence to support topiramate for the treatment of people 
      with JME. Based on the current limited available data, topiramate seems to be 
      better tolerated than valproate, but there were no more benefits of efficacy in 
      topiramate compared with valproate. In the future, well-designed, double-blind 
      RCTs with large samples are required to test the efficacy and tolerability of 
      topiramate in people with JME.
FAU - Liu, Jia
AU  - Liu J
AD  - Department of Neurology, Xuanwu Hospital, Capital Medical University, Changchun 
      Street 45, Beijing, China, 100053.
FAU - Wang, Lu-Ning
AU  - Wang LN
FAU - Wang, Yu-Ping
AU  - Wang YP
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PT  - Systematic Review
DEP - 20151223
PL  - England
TA  - Cochrane Database Syst Rev
JT  - The Cochrane database of systematic reviews
JID - 100909747
RN  - 0 (Anticonvulsants)
RN  - 0H73WJJ391 (Topiramate)
RN  - 30237-26-4 (Fructose)
RN  - 614OI1Z5WI (Valproic Acid)
SB  - IM
UIN - Cochrane Database Syst Rev. 2017 Apr 23;4:CD010008. doi: 
      10.1002/14651858.CD010008.pub3. PMID: 28434203
MH  - Adolescent
MH  - Anticonvulsants/adverse effects/*therapeutic use
MH  - Child
MH  - Fructose/adverse effects/*analogs & derivatives/therapeutic use
MH  - Humans
MH  - Myoclonic Epilepsy, Juvenile/*drug therapy
MH  - Randomized Controlled Trials as Topic
MH  - Seizures/drug therapy
MH  - Topiramate
MH  - Treatment Outcome
MH  - Valproic Acid/adverse effects/therapeutic use
MH  - Young Adult
EDAT- 2015/12/24 06:00
MHDA- 2016/04/29 06:00
CRDT- 2015/12/24 06:00
PHST- 2015/12/24 06:00 [entrez]
PHST- 2015/12/24 06:00 [pubmed]
PHST- 2016/04/29 06:00 [medline]
AID - 10.1002/14651858.CD010008.pub2 [doi]
PST - epublish
SO  - Cochrane Database Syst Rev. 2015 Dec 23;(12):CD010008. doi: 
      10.1002/14651858.CD010008.pub2.