PMID- 28854405
OWN - NLM
STAT- MEDLINE
DCOM- 20180615
LR  - 20220330
IS  - 1532-2688 (Electronic)
IS  - 1059-1311 (Linking)
VI  - 51
DP  - 2017 Oct
TI  - Newer antiepileptic drugs compared to levetiracetam as adjunctive treatments for 
      uncontrolled focal epilepsy: An indirect comparison.
PG  - 121-132
LID - S1059-1311(17)30404-1 [pii]
LID - 10.1016/j.seizure.2017.07.017 [doi]
AB  - PURPOSE: Newer antiepileptic drugs (AEDs), such as Eslicarbazepine (ESL), 
      Lacosamide (LAC), Perampanel (PER) and Brivaracetam (BRV), have been marketed as 
      adjunctive treatments for partial-onset seizures. Our aim was to compare the 
      efficacy and tolerability of newer AEDs with Levetiracetam (LEV), when used as 
      add-on treatments for uncontrolled focal epilepsy. METHOD: We conducted an online 
      database search on PubMed, Embase, Cochrane Online Library and Clinicaltrials.gov 
      for all available randomized controlled trials (RCTs) investigating the 
      therapeutic effects of newer AEDs or LEV vs placebo. Indirect comparisons for 
      clinical efficacy and tolerability at different doses between the newer AEDs and 
      LEV were then performed using Indirect Treatment Comparison (ITC) software. 
      RESULTS: Twenty-four RCTs with a total of 8540 patients were included. Compared 
      to LEV, ESL, LAC and BRV did not showed significant difference in efficacy at all 
      dose level. PER showed lower 50% response rates and seizure-free rates at the 
      highest effective recommended dosages. Treatment-emergent adverse events (TEAEs) 
      and withdrawal rates due to adverse events (AEs) of LAC and PER were higher than 
      LEV at the highest effective recommended dosages, and overall AE rates from ESL 
      were higher than LEV. CONCLUSIONS: Indirect comparisons suggested that ESL, LAC 
      and BRV were not inferior to LEV in efficacy. ESL, LAC and PER may have a 
      possible worse tolerability profile compared to LEV at high dose. But BRV may 
      exhibit a similar tolerability to LEV. Newer AEDs cannot exceed the LEV on 
      efficacy and tolerability.
CI  - Copyright (c) 2017. Published by Elsevier Ltd.
FAU - Zhu, Li-Na
AU  - Zhu LN
AD  - Department of Neurology, West China Hospital, Sichuan University, Wai Nan Guo Xue 
      Lane 37 #, Chengdu 610041, Sichuan, China. Electronic address: 
      Angelinazhuzhu@163.com.
FAU - Chen, Deng
AU  - Chen D
AD  - Department of Neurology, West China Hospital, Sichuan University, Wai Nan Guo Xue 
      Lane 37 #, Chengdu 610041, Sichuan, China. Electronic address: jerry.k.d@163.com.
FAU - Xu, Da
AU  - Xu D
AD  - Department of Neurology, West China Hospital, Sichuan University, Wai Nan Guo Xue 
      Lane 37 #, Chengdu 610041, Sichuan, China. Electronic address: 498688793@qq.com.
FAU - Tan, Ge
AU  - Tan G
AD  - Department of Neurology, West China Hospital, Sichuan University, Wai Nan Guo Xue 
      Lane 37 #, Chengdu 610041, Sichuan, China. Electronic address: 
      tanhaoshua@163.com.
FAU - Wang, Hai-Jiao
AU  - Wang HJ
AD  - Department of Neurology, West China Hospital, Sichuan University, Wai Nan Guo Xue 
      Lane 37 #, Chengdu 610041, Sichuan, China. Electronic address: 844675111@qq.com.
FAU - Liu, Ling
AU  - Liu L
AD  - Department of Neurology, West China Hospital, Sichuan University, Wai Nan Guo Xue 
      Lane 37 #, Chengdu 610041, Sichuan, China. Electronic address: 
      zjllxx1968@163.com.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20170816
PL  - England
TA  - Seizure
JT  - Seizure
JID - 9306979
RN  - 0 (Anticonvulsants)
RN  - 44YRR34555 (Levetiracetam)
RN  - ZH516LNZ10 (Piracetam)
SB  - IM
MH  - Anticonvulsants/*therapeutic use
MH  - Epilepsies, Partial/*drug therapy
MH  - Humans
MH  - Levetiracetam
MH  - Piracetam/*analogs & derivatives/therapeutic use
OTO - NOTNLM
OT  - Adverse events
OT  - Antiepileptic drugs
OT  - Efficacy
OT  - Tolerability
EDAT- 2017/08/31 06:00
MHDA- 2018/06/16 06:00
CRDT- 2017/08/31 06:00
PHST- 2017/06/09 00:00 [received]
PHST- 2017/07/26 00:00 [revised]
PHST- 2017/07/29 00:00 [accepted]
PHST- 2017/08/31 06:00 [pubmed]
PHST- 2018/06/16 06:00 [medline]
PHST- 2017/08/31 06:00 [entrez]
AID - S1059-1311(17)30404-1 [pii]
AID - 10.1016/j.seizure.2017.07.017 [doi]
PST - ppublish
SO  - Seizure. 2017 Oct;51:121-132. doi: 10.1016/j.seizure.2017.07.017. Epub 2017 Aug 
      16.