Levetiracetam versus Oxcarbazepine as monotherapy in newly diagnosed focal epilepsy: A systematic review and meta‐analysis
Abstract Objective To compare the efficacy and safety of Levetiracetam (LEV) and Oxcarbazepine (OXC) as monotherapy for the treatment of newly diagnosed focal epilepsy. Methods We searched PubMed, Cochrane Library, EMBASE, and Google Scholar from January 1, 2000 to May 11, 2022, with no language res...
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| Format: | Article |
| Language: | English |
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Wiley
2022-11-01
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| Series: | Brain and Behavior |
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| Online Access: | https://doi.org/10.1002/brb3.2779 |
| _version_ | 1828116448504971264 |
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| author | Sanjeev Kharel Rajeev Ojha Surendra Khanal |
| author_facet | Sanjeev Kharel Rajeev Ojha Surendra Khanal |
| author_sort | Sanjeev Kharel |
| collection | DOAJ |
| description | Abstract Objective To compare the efficacy and safety of Levetiracetam (LEV) and Oxcarbazepine (OXC) as monotherapy for the treatment of newly diagnosed focal epilepsy. Methods We searched PubMed, Cochrane Library, EMBASE, and Google Scholar from January 1, 2000 to May 11, 2022, with no language restrictions along with The ClinicalTrials.gov website and the WHO International Controlled Trials Registry platforms. We pooled the risk ratio (RR) and corresponding 95% confidence interval (95% CI) for the efficacy and safety outcomes. The quality of included trials was assessed using the Cochrane Collaboration's tool. Results Two RCTs included a total of 574 newly diagnosed focal epilepsy patients (the LEV group [282 patients] and the OXC group [292 patients]). LEV group when compared with the OXC group had no significant difference in the pooled estimate of seizure freedom at week 24. (RR: 0.81; 95% CI: 0.62–1.05, p = .11). Similarly, there was no significant difference in the pooled estimate of withdrawal due to adverse events (AEs) (RR: 0.87; 95% CI: 0.34–2.23, p = .77). The commonly reported AEs in both trials were dizziness, headache, rash, somnolence, and nasopharyngitis with zero medication‐related death and few serious AEs. Conclusions LEV is noninferior to OXC in terms of seizure freedom at week 24 and treatment withdrawal rate due to AEs among adults but long‐term treatment data is still missing. Future multicentric double‐blinded RCTs and real‐world studies are of great need. |
| first_indexed | 2024-04-11T12:57:01Z |
| format | Article |
| id | doaj.art-4120ea677c8e4b9da249fb706b2dd254 |
| institution | Directory Open Access Journal |
| issn | 2162-3279 |
| language | English |
| last_indexed | 2024-04-11T12:57:01Z |
| publishDate | 2022-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Brain and Behavior |
| spelling | doaj.art-4120ea677c8e4b9da249fb706b2dd2542022-12-22T04:23:03ZengWileyBrain and Behavior2162-32792022-11-011211n/an/a10.1002/brb3.2779Levetiracetam versus Oxcarbazepine as monotherapy in newly diagnosed focal epilepsy: A systematic review and meta‐analysisSanjeev Kharel0Rajeev Ojha1Surendra Khanal2Maharajgunj Medical Campus Tribhuvan University Institute of Medicine, Maharajgunj Kathmandu NepalDepartment of Neurology Tribhuvan University Teaching Hospital, Maharajgunj Kathmandu NepalMaharajgunj Medical Campus Tribhuvan University Institute of Medicine, Maharajgunj Kathmandu NepalAbstract Objective To compare the efficacy and safety of Levetiracetam (LEV) and Oxcarbazepine (OXC) as monotherapy for the treatment of newly diagnosed focal epilepsy. Methods We searched PubMed, Cochrane Library, EMBASE, and Google Scholar from January 1, 2000 to May 11, 2022, with no language restrictions along with The ClinicalTrials.gov website and the WHO International Controlled Trials Registry platforms. We pooled the risk ratio (RR) and corresponding 95% confidence interval (95% CI) for the efficacy and safety outcomes. The quality of included trials was assessed using the Cochrane Collaboration's tool. Results Two RCTs included a total of 574 newly diagnosed focal epilepsy patients (the LEV group [282 patients] and the OXC group [292 patients]). LEV group when compared with the OXC group had no significant difference in the pooled estimate of seizure freedom at week 24. (RR: 0.81; 95% CI: 0.62–1.05, p = .11). Similarly, there was no significant difference in the pooled estimate of withdrawal due to adverse events (AEs) (RR: 0.87; 95% CI: 0.34–2.23, p = .77). The commonly reported AEs in both trials were dizziness, headache, rash, somnolence, and nasopharyngitis with zero medication‐related death and few serious AEs. Conclusions LEV is noninferior to OXC in terms of seizure freedom at week 24 and treatment withdrawal rate due to AEs among adults but long‐term treatment data is still missing. Future multicentric double‐blinded RCTs and real‐world studies are of great need.https://doi.org/10.1002/brb3.2779focal epilepsyLevetiracetammonotherapyOxcarbazepine |
| spellingShingle | Sanjeev Kharel Rajeev Ojha Surendra Khanal Levetiracetam versus Oxcarbazepine as monotherapy in newly diagnosed focal epilepsy: A systematic review and meta‐analysis Brain and Behavior focal epilepsy Levetiracetam monotherapy Oxcarbazepine |
| title | Levetiracetam versus Oxcarbazepine as monotherapy in newly diagnosed focal epilepsy: A systematic review and meta‐analysis |
| title_full | Levetiracetam versus Oxcarbazepine as monotherapy in newly diagnosed focal epilepsy: A systematic review and meta‐analysis |
| title_fullStr | Levetiracetam versus Oxcarbazepine as monotherapy in newly diagnosed focal epilepsy: A systematic review and meta‐analysis |
| title_full_unstemmed | Levetiracetam versus Oxcarbazepine as monotherapy in newly diagnosed focal epilepsy: A systematic review and meta‐analysis |
| title_short | Levetiracetam versus Oxcarbazepine as monotherapy in newly diagnosed focal epilepsy: A systematic review and meta‐analysis |
| title_sort | levetiracetam versus oxcarbazepine as monotherapy in newly diagnosed focal epilepsy a systematic review and meta analysis |
| topic | focal epilepsy Levetiracetam monotherapy Oxcarbazepine |
| url | https://doi.org/10.1002/brb3.2779 |
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