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奥卡西平治疗儿童癫痫的疗效与安全性:随机对照试验的荟萃分析

Efficacy and safety of oxcarbazepine in the treatment of children with epilepsy: a meta-analysis of randomized controlled trials.

作者信息

Geng Hua, Wang Chengzhong

机构信息

Department of Pediatrics, Maternal and Child Health Hospital of Yancheng, Yancheng City, People's Republic of China.

出版信息

Neuropsychiatr Dis Treat. 2017 Mar 2;13:685-695. doi: 10.2147/NDT.S130269. eCollection 2017.

Abstract

BACKGROUND

To assess the efficacy and safety of oxcarbazepine (OXC) in the treatment of children with epilepsy.

METHODS

Randomized controlled trials (RCTs) published in PubMed, Embase, Web of Science, Cochrane Library, Scopus, SinoMed (Chinese BioMedical Literature Service System, China), and Chinese National Knowledge Infrastructure (China) database were systematically reviewed. Eligible studies were those that compared the efficacy and safety of OXC with other antiepileptic drugs in epilepsy. Risk ratio (RR) with 95% confidence intervals (95% CIs) was calculated using fixed-effects or random-effects model.

RESULTS

Eleven RCTs with a total of 1,241 patients met the inclusion criteria and were included in this meta-analysis. Compared with other antiepileptic drugs (sodium valproate, levetiracetam, phenytoin, and placebo), OXC was associated with similar seizure-free rate (RR =1.06, 95% CI: 0.94, 1.20; =0.366) and percentage reduction from baseline in seizure frequency (for ≥75% reduction: RR =1.15, 95% CI: 0.88, 1.49; =0.310; for 50%-75% reduction: RR =1.12, 95% CI: 0.90, 1.39; =0.301; for <50% reduction: RR =0.79, 95% CI: 0.56, 1.12; =0.179). Moreover, patients treated with OXC had a comparable incidence of adverse events compared with those treated with other antiepileptic drugs (RR =1.01, 95% CI: 0.92, 1.11; =0.760).

CONCLUSION

OXC showed similar effects and safety as other antiepileptic drugs in the treatment of children with epilepsy. Further well-conducted, large-scale RCTs are needed to validate these findings.

摘要

背景

评估奥卡西平(OXC)治疗儿童癫痫的疗效和安全性。

方法

系统回顾发表于PubMed、Embase、科学引文索引、考克兰图书馆、Scopus、中国生物医学文献服务系统(SinoMed)以及中国知网数据库的随机对照试验(RCT)。符合条件的研究为比较奥卡西平与其他抗癫痫药物治疗癫痫的疗效和安全性的研究。采用固定效应或随机效应模型计算风险比(RR)及95%置信区间(95%CI)。

结果

11项RCT共1241例患者符合纳入标准并纳入本荟萃分析。与其他抗癫痫药物(丙戊酸钠、左乙拉西坦、苯妥英和安慰剂)相比,奥卡西平的无癫痫发作率相似(RR = 1.06,95%CI:0.94,1.20;P = 0.366),癫痫发作频率较基线降低的百分比也相似(降低≥75%:RR = 1.15,95%CI:0.88,1.49;P = 0.310;降低50%-75%:RR = 1.12,95%CI:0.90,1.39;P = 0.301;降低<50%:RR = 0.79,95%CI:0.56,1.12;P = 0.179)。此外,与接受其他抗癫痫药物治疗的患者相比,接受奥卡西平治疗的患者不良事件发生率相当(RR = 1.01,95%CI:0.92,1.11;P = 0.760)。

结论

奥卡西平在治疗儿童癫痫方面显示出与其他抗癫痫药物相似的效果和安全性。需要进一步开展设计良好的大规模RCT来验证这些发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b158/5342615/2791e933d850/ndt-13-685Fig1.jpg

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