Cochrane · systematic review · CD001769

Sodium valproate versus phenytoin monotherapy for epilepsy: an individual participant data review

Nevitt, SJ, Marson, AG, Weston, J, et al. · Cochrane Database of Systematic Reviews · 2018 · Cochrane Library

Epilepsy3 versionsAMSTAR 2: not assessed
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
9
current version
GRADE rated
9
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 0 · 0%Low 4 · 44.4%Moderate 5 · 55.6%High 0 · 0%

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

Show all 3 versions

Sodium valproate compared with phenytoin monotherapy for epilepsy (primary outcome)

Population: adults and children with newly‐onset focal onset or generalised tonic‐clonic seizures
3 questions
OutcomeEffectEvidenceStatus / GRADE
Time to treatment failure (any reason related to treatment) All participants Range of
Sodium valproate vs phenytoin monotherapy
HR 0.88 [0.61, 1.27]5 studies · 528 participantsModerate
Downgraded: risk of bias
Time to treatment failure (any reason related to treatment) Subgroup: focal onset seizures Range of
Sodium valproate vs phenytoin monotherapy
HR 0.83 [0.5, 1.38]4 studies · 187 participantsModerate
Downgraded: risk of bias
Time to treatment failure (any reason related to treatment) Subgroup: generalised onset seizures (tonic‐clonic only) Range of
Sodium valproate vs phenytoin monotherapy
HR 0.94 [0.55, 1.61]5 studies · 341 participantsLow
Downgraded: risk of bias, inconsistency

Sodium valproate compared with phenytoin monotherapy for epilepsy (secondary outcomes)

Population: adults and children with newly‐onset focal onset or generalised tonic‐clonic seizures
6 questions
OutcomeEffectEvidenceStatus / GRADE
Time to first seizure (post‐randomisation) All participants Range of
Sodium valproate vs phenytoin monotherapy
HR 1.08 [0.88, 1.33]5 studies · 639 participantsLow
Downgraded: risk of bias, indirectness
Time to first seizure (post‐randomisation) Subgroup: focal onset seizures Range of
Sodium valproate vs phenytoin monotherapy
HR 1.2 [0.9, 1.6]4 studies · 244 participantsLow
Downgraded: risk of bias, indirectness
Time to first seizure (post‐randomisation) Subgroup: generalised onset seizures (tonic‐clonic only) Range of
Sodium valproate vs phenytoin monotherapy
HR 0.97 [0.72, 1.3]5 studies · 395 participantsLow
Downgraded: risk of bias, indirectness
Time to achieve 12‐month remission (seizure‐free period) All participants Range of
Sodium valproate vs phenytoin monotherapy
HR 1.02 [0.81, 1.28]4 studies · 514 participantsModerate
Downgraded: risk of bias
Time to achieve 12‐month remission (seizure‐free period) Subgroup: focal onset seizures Range of
Sodium valproate vs phenytoin monotherapy
HR 1.11 [0.78, 1.6]4 studies · 244 participantsModerate
Downgraded: risk of bias
Time to achieve 12‐month remission (seizure‐free period) Subgroup: generalised onset seizures (tonic‐clonic only) Range of
Sodium valproate vs phenytoin monotherapy
HR 0.96 [0.71, 1.29]4 studies · 270 participantsModerate
Downgraded: risk of bias