PMID- 28434203
OWN - NLM
STAT- MEDLINE
DCOM- 20170801
LR  - 20200225
IS  - 1469-493X (Electronic)
IS  - 1361-6137 (Linking)
VI  - 4
IP  - 4
DP  - 2017 Apr 23
TI  - Topiramate monotherapy for juvenile myoclonic epilepsy.
PG  - CD010008
LID - 10.1002/14651858.CD010008.pub3 [doi]
LID - CD010008
AB  - BACKGROUND: Topiramate is a newer broad-spectrum 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. This is an updated version of the original Cochrane Review 
      published in Issue 12, 2015. OBJECTIVES: To evaluate the efficacy and 
      tolerability of topiramate monotherapy in the treatment of JME. SEARCH METHODS: 
      For the latest update, on 21 February 2017 we searched Cochrane Epilepsy's 
      Specialized Register, CENTRAL, MEDLINE, and ClinicalTrials.gov. We also searched 
      ongoing trials registers, reference lists and relevant conference proceedings, 
      and contacted study 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 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: Since the 
      last version of this review we found no new studies. 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
AD  - Department of Geriatric Neurology, Chinese PLA General Hospital, Fuxing Road 28, 
      Haidian District, Beijing, China, 100853.
FAU - Wang, Yu-Ping
AU  - Wang YP
AD  - Department of Neurology, Xuanwu Hospital, Capital Medical University, Changchun 
      Street 45, Beijing, China, 100053.
LA  - eng
PT  - Journal Article
PT  - Review
PT  - Systematic Review
DEP - 20170423
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
UOF - Cochrane Database Syst Rev. 2015 Dec 23;(12):CD010008. PMID: 26695884
UIN - Cochrane Database Syst Rev. 2019 Jan 28;1:CD010008. PMID: 30687937
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
PMC - PMC6478307
COIS- Jia Liu; none known Lu-Ning Wang: none known Yu-Ping Wang: none known
EDAT- 2017/04/24 06:00
MHDA- 2017/08/02 06:00
PMCR- 2018/04/23
CRDT- 2017/04/24 06:00
PHST- 2017/04/24 06:00 [pubmed]
PHST- 2017/08/02 06:00 [medline]
PHST- 2017/04/24 06:00 [entrez]
PHST- 2018/04/23 00:00 [pmc-release]
AID - CD010008 [pii]
AID - 10.1002/14651858.CD010008.pub3 [doi]
PST - epublish
SO  - Cochrane Database Syst Rev. 2017 Apr 23;4(4):CD010008. doi: 
      10.1002/14651858.CD010008.pub3.