Efficacy and safety of antiseizure medication for Lennox–Gastaut syndrome: a systematic review and network meta‐analysis

大麻酚 Lennox-Gastaut综合征 拉莫三嗪 克洛巴扎姆 托吡酯 医学 Dravet综合征 安慰剂 非尔巴酸盐 随机对照试验 麻醉 癫痫 不利影响 内科学 精神科 大麻 替代医学 病理
作者
Lanlan Zhang,Juan Wang,Chengzhong Wang
出处
期刊:Developmental Medicine & Child Neurology [Wiley]
卷期号:64 (3): 305-313 被引量:13
标识
DOI:10.1111/dmcn.15072
摘要

To compare and rank the efficacy and safety of antiseizure medication (ASM) in patients with Lennox-Gastaut syndrome (LGS).We included randomized controlled trials (RCTs) assessing the efficacy of ASM for LGS compared with placebo or with each other. The efficacy and safety were reported in terms of an at least 50% monthly seizure frequency reduction in drop seizures, dropout, and serious adverse events. Outcomes were ranked according to the surface under the cumulative ranking curve (SUCRA).A total of eight RCTs with 1171 patients were included, involving six ASMs: lamotrigine, rufinamide, cannabidiol, topiramate, clobazam, and felbamate. The calculated SUCRA showed that rufinamide, cannabidiol, and topiramate had the highest probability of achieving a response; however, no significant differences were found among these treatments. Cannabidiol, topiramate, and rufinamide were more likely to result in dropouts; moreover, a significantly greater percentage of patients receiving cannabidiol experienced premature discontinuation as compared to placebo, clobazam, and lamotrigine.All ASMs showed a significantly higher response rate than placebo. SUCRA ranking demonstrated that rufinamide and cannabidiol are more efficacious than other treatments in reducing drop seizures. However, there was no significant difference between these treatments.
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