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The efficacy and safety of lamotrigine for absence seizures in children and adolescents: A systematic review and meta-analysis.

Abstract

AIMS

This systematic review and meta-analysis of randomized controlled trials (RCTs) systematically explored the effectiveness and safety of lamotrigine for absence seizures in children and adolescents.

METHODS

Keywords searches were conducted in Pubmed Embase Cochrane Central Register of Controlled Trials Wanfang CNKI from inception through March 2019. The RCTs comparing lamotrigine with other drugs and/or placebo for the treatment of absence seizures in children and adolescents were considered in this study. The study was conducted adhering to PRISMA guidelines.

RESULTS

Eight RCTs (n = 787) were included in our study. Among these studies, one study (N = 45 patients) used placebo as a control and seven studies (N = 742 patients) used positive drug controls. For effectiveness, there was significant difference between lamotrigine and valproate [OR = 0.42, 95%CI (0.28-0.63), I2 = 0%] or ethosuximide [OR = 0.34, 95%CI (0.22-0.53), I2 = 0%]. For adverse effects (AEs), there was no significant difference between lamotrigine and valproate [OR = 1.17, 95%CI (0.59, 2.32), I2 = 0%] or ethosuximide [OR = 0.75, 95%CI (0.47, 1.19), I2 = 92%], and the most common adverse effects of lamotrigine were Rash (7.88%), Fatigue (6.50%) and Headache (6.50%).

CONCLUSIONS

According to current evidence, LTG is less effective than VPA and ESM, however, based on its relative safety, LTG might be reasonably tried as initial therapy in children and adolescents at risk of significant adverse effects from VPA and ESM, and future well-designed studies are needed to confirm our findings.

Authors+Show Affiliations

Department of Traditional Chinese Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China; Nanjing Medical University, Nanjing, China.The First Hospital of Lanzhou, Lanzhou, China.Chaohu Hospital of Anhui Medical University, Anhui, China. Electronic address: drhuanzhongliu@126.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31466903

Citation

Cao, Jing, et al. "The Efficacy and Safety of Lamotrigine for Absence Seizures in Children and Adolescents: a Systematic Review and Meta-analysis." Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia, 2019.
Cao J, Lin XX, Ma XM, et al. The efficacy and safety of lamotrigine for absence seizures in children and adolescents: A systematic review and meta-analysis. J Clin Neurosci. 2019.
Cao, J., Lin, X. X., Ma, X. M., & Liu, H. (2019). The efficacy and safety of lamotrigine for absence seizures in children and adolescents: A systematic review and meta-analysis. Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia, doi:10.1016/j.jocn.2019.08.043.
Cao J, et al. The Efficacy and Safety of Lamotrigine for Absence Seizures in Children and Adolescents: a Systematic Review and Meta-analysis. J Clin Neurosci. 2019 Aug 26; PubMed PMID: 31466903.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The efficacy and safety of lamotrigine for absence seizures in children and adolescents: A systematic review and meta-analysis. AU - Cao,Jing, AU - Lin,Xiao-Xiao, AU - Ma,Xiang-Ming, AU - Liu,Huanzhong, Y1 - 2019/08/26/ PY - 2019/06/30/received PY - 2019/08/05/accepted PY - 2019/8/31/entrez KW - Absence seizures KW - Children and adolescents KW - Efficacy KW - Lamotrigine KW - Meta-analysis JF - Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia JO - J Clin Neurosci N2 - AIMS: This systematic review and meta-analysis of randomized controlled trials (RCTs) systematically explored the effectiveness and safety of lamotrigine for absence seizures in children and adolescents. METHODS: Keywords searches were conducted in Pubmed Embase Cochrane Central Register of Controlled Trials Wanfang CNKI from inception through March 2019. The RCTs comparing lamotrigine with other drugs and/or placebo for the treatment of absence seizures in children and adolescents were considered in this study. The study was conducted adhering to PRISMA guidelines. RESULTS: Eight RCTs (n = 787) were included in our study. Among these studies, one study (N = 45 patients) used placebo as a control and seven studies (N = 742 patients) used positive drug controls. For effectiveness, there was significant difference between lamotrigine and valproate [OR = 0.42, 95%CI (0.28-0.63), I2 = 0%] or ethosuximide [OR = 0.34, 95%CI (0.22-0.53), I2 = 0%]. For adverse effects (AEs), there was no significant difference between lamotrigine and valproate [OR = 1.17, 95%CI (0.59, 2.32), I2 = 0%] or ethosuximide [OR = 0.75, 95%CI (0.47, 1.19), I2 = 92%], and the most common adverse effects of lamotrigine were Rash (7.88%), Fatigue (6.50%) and Headache (6.50%). CONCLUSIONS: According to current evidence, LTG is less effective than VPA and ESM, however, based on its relative safety, LTG might be reasonably tried as initial therapy in children and adolescents at risk of significant adverse effects from VPA and ESM, and future well-designed studies are needed to confirm our findings. SN - 1532-2653 UR - https://www.unboundmedicine.com/medline/citation/31466903/The_efficacy_and_safety_of_lamotrigine_for_absence_seizures_in_children_and_adolescents:_A_systematic_review_and_meta-analysis L2 - https://linkinghub.elsevier.com/retrieve/pii/S0967-5868(19)31268-8 DB - PRIME DP - Unbound Medicine ER -