Cochrane · systematic review · CD001417
Topiramate add‐on therapy for drug‐resistant focal epilepsy
Bresnahan, R, Hounsome, J, Jette, N, et al. · Cochrane Database of Systematic Reviews · 2019 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
7
current version
GRADE rated
7
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 0 · 0%Low 1 · 14.3%Moderate 3 · 42.9%High 3 · 42.9%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyTopiramate compared to placebo for drug‐resistant focal epilepsy
Population: people with drug‐resistant focal epilepsy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
50% or greater reduction in seizure frequency (ITT analysis) Topiramate vs placebo | RR 2.71 [2.05, 3.59] | 12 studies · 1650 participants | High |
Seizure freedom Topiramate vs placebo | RR 3.67 [1.79, 7.54] | 8 studies · 1177 participants | Moderate Downgraded: risk of bias, imprecision |
Treatment withdrawal Topiramate vs placebo | RR 2.37 [1.66, 3.37] | 12 studies · 1650 participants | High |
Adverse effects ‐ weight loss/decrease Topiramate vs placebo | RR 3.99 [1.82, 8.72] | 9 studies · 1070 participants | Low Downgraded: risk of bias, imprecision, publication bias |
Adverse effects ‐ paraesthesia Topiramate vs placebo | RR 3.65 [1.58, 8.39] | 7 studies · 1071 participants | Moderate Downgraded: risk of bias, imprecision |
Adverse effects ‐ 'thinking abnormally' Topiramate vs placebo | RR 5.7 [2.26, 14.38] | 4 studies · 640 participants | High |
Adverse effects ‐ difficulty with concentration/concentration impaired/concentration‐attention difficulties Topiramate vs placebo | RR 7.81 [2.08, 29.29] | 6 studies · 702 participants | Moderate Downgraded: risk of bias, imprecision, publication bias |
Topiramate versus placebo for drug‐resistant partial epilepsy
Population: patients with drug‐resistant partial epilepsy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
50% reduction in seizure frequency ‐ ITT analysis Topiramate vs placebo | RR 2.97 [2.38, 3.72] | 11 studies · 1401 participants | Moderate Downgraded: publication bias |
Seizure freedom Topiramate vs placebo | RR 3.41 [1.37, 8.51] | 5 studies · 633 participants | Moderate Downgraded: imprecision |
Treatment withdrawal Topiramate vs placebo | RR 2.44 [1.64, 3.62] | 10 studies · 1315 participants | Low Downgraded: imprecision, publication bias |
Side effects ‐ weight loss/decrease Topiramate vs placebo | no estimate extracted | 8 studies · 821 participants | Moderate Downgraded: imprecision |
Side effects ‐ paraesthesia Topiramate vs placebo | no estimate extracted | 6 studies · 822 participants | Moderate Downgraded: imprecision |
Side effects ‐ thinking abnormally Topiramate vs placebo | no estimate extracted | 4 studies · 640 participants | Moderate Downgraded: imprecision |
Side effects ‐ difficulty with concentration/concentration impaired/concentration‐attention difficulties Topiramate vs placebo | no estimate extracted | 6 studies · 702 participants | Moderate Downgraded: imprecision |