Efficacy And Safety Of Topiramate And Carbamazepine Monotherapy For Partial Seizures Patients:A Meta-Analysis

BackgroundEpilepsy has a high prevalence in China and can occur at all ages,seriously affecting the quality of life of patients.At present,drug treatment is the main means to control seizures and improve the quality of life of patients.Carbamazepine(CBZ)is currently the first line of recommendation for the treatment of partial seizure(PS).Topiramate(TPM)is a new broad-spectrum antiepileptic drug(AEDs)that is effective for all types of seizures.It is used for monotherapy in patients with newly diagnosed epilepsy or in epilepsy patients who was treated with drug combination but now have been converted to monotherapy,and it is also used for combination treatment for PS patients who are adults and children aged 2 to 16 years.Compared with CBZ,TPM has the advantage of anti-epileptic broad spectrum,linear pharmacokinetics and safety.However,whether TPM monotherapy is better than CBZ is still controversial.ObjectiveTo evaluate the efficacy and safety of TPM and CBZ monotherapy for PS,and to provide evidence for clinical medication use.MethodsThe computer was searched in PubMed,Cochrane,Embase,China Knowledge Network(CNKI),Wanfang Database and China Biomedical Literature Database for a clinical controlled trial literature on TPM and CBZ monotherapy for PS patients from their initial establishment of database to January 31,2019.These literatures were subjected toliterature screening,data extraction,literature quality and risk bias assessment,cross-checking,and data analysis using Meta analysis software Revman 5.3.ResultsThere were 459 literatures in the initial examination,and 12 literatures were finally adopted.There were 2348 patients,including 1075 in the TPM group and 1273 in the CBZ group.Among them,there are 3 high-quality literatures and 9 low-quality literatures.Meta-analysis showed that there were 540 cases without clinical epileptic seizures in the TPM group,accounting for 52.38%(540/1031).There were 546 cases without clinical epileptic seizures in the CBZ group,accounting for 45.73%(546/1194),and the difference between the two groups was statistically significant [OR= 1.53,95% CI(1.05,2.24),P =0.03].204 cases were effective in the TPM group,accounting for 37.02%(204/551);326cases were effective in the CBZ group,accounting for 47.52%(326/686).There was no significant difference between the two groups [OR = 0.91,95% CI(0.70,1.19).),P =0.51].There were 372 cases of adverse reactions in the TPM group,accounting for39.45%(372/943).There were 466 cases of adverse reactions in the CBZ group,accounting for 44.72%(466/1042).The difference between the two groups was statistically significant [OR = 0.75,95% CI(0.56,1.00),P = 0.05].Conclusions1.For the treatment of PS,the control rate of TPM is higher than CBZ.2.For the treatment of PS,the adverse reaction rate of TPM is lower than CBZ.3.For the treatment of PS,TPM has good effect,less adverse reactions and high safety.