PMID- 30096625
OWN - NLM
STAT- MEDLINE
DCOM- 20181113
LR  - 20181202
IS  - 1532-2688 (Electronic)
IS  - 1059-1311 (Linking)
VI  - 61
DP  - 2018 Oct
TI  - Randomized controlled trials of antiepileptic drugs for the treatment of 
      post-stroke seizures: A systematic review with network meta-analysis.
PG  - 57-62
LID - S1059-1311(18)30344-3 [pii]
LID - 10.1016/j.seizure.2018.08.001 [doi]
AB  - OBJECTIVE: To determine the best available evidence on the efficacy and 
      tolerability of antiepileptic drugs (AEDs) used to treat poststroke seizures and 
      epilepsy. METHODS: MEDLINE, Embase, CENTRAL, ClinicalTrials.gov and Opengrey.eu 
      were searched for RCTs of AEDs used to treat post-stroke epilepsy. The following 
      outcomes were considered: seizure freedom; occurrence of adverse effects (AEs); 
      withdrawal for AEs. The methodological quality was assessed according to the 
      Cochrane Handbook for Systematic Reviews of Interventions. Adjusted indirect 
      comparisons were made between each AED using controlled-release carbamazepine 
      (CR-CBZ) as common comparator. RESULTS: Only 2 RCTs were included, one comparing 
      levetiracetam (LEV) with CR-CBZ and the other comparing lamotrigine (LTG) with 
      CR-CBZ. No significant difference was found in seizure freedom between either LEV 
      or LTG and CR-CBZ. Occurrence of AEs were lower for LEV and LTG than for CR-CBZ. 
      Indirect comparisons showed no difference between LEV and LTG for seizure freedom 
      (OR 0.86; 95%CI: 0.15-4.89). Occurrence of AEs was higher for LEV than for LTG 
      (OR 6.87; 95%CI: 1.15-41.1). For withdrawal rates due to AEs, we found a large 
      width and asymmetrical distribution of confidence intervals around the obtained 
      OR of 10.8 (95% CI: 0.78-149.71). CONCLUSIONS: Direct and indirect comparisons 
      did not find a difference in seizure freedom between the various AEDs, probably 
      because of the small number of patients included. LEV and LTG appears better 
      tolerated than CR-CBZ and LEV seems associated with more AEs than LTG. Further 
      studies are required to provide robust evidence on efficacy and tolerability of 
      AEDs for treating poststroke epilepsy.
CI  - Copyright (c) 2018 British Epilepsy Association. Published by Elsevier Ltd. All 
      rights reserved.
FAU - Brigo, F
AU  - Brigo F
AD  - Department of Neurosciences, Biomedicine and Movement Sciences, University of 
      Verona, Verona, Italy; Division of Neurology, "Franz Tappeiner" Hospital, Merano, 
      Italy. Electronic address: dr.francescobrigo@gmail.com.
FAU - Lattanzi, S
AU  - Lattanzi S
AD  - Neurological Clinic, Department of Experimental and Clinical Medicine, Marche 
      Polytechnic University, Ancona, Italy.
FAU - Zelano, J
AU  - Zelano J
AD  - Sahlgrenska university hospital, Gothenburg Sweden; Sahlgrenska academy, 
      Department of neuroscience and physiology, University of Gothenburg, Sweden.
FAU - Bragazzi, N L
AU  - Bragazzi NL
AD  - Department of Health Sciences (DISSAL), School of Public Health, University of 
      Genoa, Genoa, Italy.
FAU - Belcastro, V
AU  - Belcastro V
AD  - Neurology Unit, S. Anna Hospital, Como, Italy.
FAU - Nardone, R
AU  - Nardone R
AD  - Division of Neurology, "Franz Tappeiner" Hospital, Merano, Italy; Department of 
      Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, 
      Austria.
FAU - Trinka, E
AU  - Trinka E
AD  - Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, 
      Salzburg, Austria; Center for Cognitive Neuroscience, Salzburg, Austria; Public 
      Health, Health Services Research and HTA, University for Health Sciences, Medical 
      Informatics and Technology, Hall i.T, Austria.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20180803
PL  - England
TA  - Seizure
JT  - Seizure
JID - 9306979
RN  - 0 (Anticonvulsants)
SB  - IM
MH  - Anticonvulsants/*therapeutic use
MH  - Humans
MH  - *Randomized Controlled Trials as Topic
MH  - Seizures/*drug therapy/etiology
MH  - Stroke/complications
OTO - NOTNLM
OT  - Controlled-release carbamazepine
OT  - Efficacy
OT  - Lamotrigine
OT  - Levetiracetam
OT  - Poststroke epilepsy
OT  - Tolerability
EDAT- 2018/08/11 06:00
MHDA- 2018/11/14 06:00
CRDT- 2018/08/11 06:00
PHST- 2018/05/26 00:00 [received]
PHST- 2018/07/23 00:00 [revised]
PHST- 2018/08/02 00:00 [accepted]
PHST- 2018/08/11 06:00 [pubmed]
PHST- 2018/11/14 06:00 [medline]
PHST- 2018/08/11 06:00 [entrez]
AID - S1059-1311(18)30344-3 [pii]
AID - 10.1016/j.seizure.2018.08.001 [doi]
PST - ppublish
SO  - Seizure. 2018 Oct;61:57-62. doi: 10.1016/j.seizure.2018.08.001. Epub 2018 Aug 3.