Song Ting, Feng Lingjun, Xia Yulei, Pang Meng, Geng Jianhong, Zhang Xiaojun, Wang Yanqiang
Department of Neurology II, Affiliated Hospital of Weifang Medical University, Weifang, China.
Surgical Department, Affiliated Hospital of Weifang Medical University, Weifang, China.
Front Neurol. 2023 Jul 6;14:1170780. doi: 10.3389/fneur.2023.1170780. eCollection 2023.
Epilepsy is one of the most common neurological diseases, affecting people of any age. Although the treatments of epilepsy are more and more diverse, the uncertainty regarding efficacy and adverse events still exists, especially in the control of childhood epilepsy.
We performed a systematic review and meta- analysis following the Cochrane Handbook and preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Four databases including PubMed, Embase, Web of Science and Cochrane library were searched. Studies reporting the use of brivaracetam monotherapy or adjuvant therapy in children (aged ≤18 years) were eligible for inclusion. Each stage of the review was conducted by two authors independently. Random-effects models were used to combine effect sizes for the estimation of efficacy and safety.
A total of 1884 articles were retrieved, and finally 9 articles were included, enrolling 503 children with epilepsy. The retention rate of BRV treatment was 78% (95% CI: 0.64-0.91), the responder rate (reduction of seizure frequency ≥ 50%) was 35% (95% CI: 0.24-0.47), the freedom seizure rate (no seizure) was 18% (95% CI: 0.10-0.25), and the incidence rate of any treatment-emergent adverse events (TEAE) was 39% (95% CI: 0.09-0.68). The most common TEAE was somnolence, which had an incidence rate of 9% (95% CI: 0.07-0.12). And the incidence rate of mental or behavioral disorders was 12% (95% CI: 0.06-0.17).
Our systematic review and meta-analysis showed that BRV seemed to be safe and effective in the treatment of childhood epilepsy.
癫痫是最常见的神经系统疾病之一，影响任何年龄段的人群。尽管癫痫的治疗方法越来越多样，但疗效和不良事件的不确定性仍然存在，尤其是在儿童癫痫的控制方面。
我们按照Cochrane手册以及系统评价和Meta分析的首选报告项目（PRISMA）指南进行了系统评价和Meta分析。检索了包括PubMed、Embase、Web of Science和Cochrane图书馆在内的四个数据库。纳入报告在儿童（年龄≤18岁）中使用布立伏胺单药治疗或辅助治疗的研究。综述的每个阶段均由两位作者独立进行。采用随机效应模型合并效应量以评估疗效和安全性。
共检索到1884篇文章，最终纳入9篇文章，涉及503例癫痫儿童。布立伏胺治疗的保留率为78%（95%CI：0.64 - 0.91），应答率（癫痫发作频率降低≥50%）为35%（95%CI：0.24 - 0.47），无癫痫发作率（无发作）为18%（95%CI：0.10 - 0.25），任何治疗中出现的不良事件（TEAE）发生率为39%（95%CI：0.09 - 0.68）。最常见的TEAE是嗜睡，发生率为9%（95%CI：0.07 - 0.12）。精神或行为障碍的发生率为12%（95%CI：0.06 - 0.17）。
我们的系统评价和Meta分析表明，布立伏胺在治疗儿童癫痫方面似乎是安全有效的。
