Cochrane · systematic review · CD001911
Carbamazepine versus phenytoin monotherapy for epilepsy: an individual participant data review
Nevitt, SJ, Marson, AG, Tudur Smith, C · 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
9
current version
GRADE rated
9
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 0 · 0%Low 3 · 33.3%Moderate 6 · 66.7%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
Current version onlyCarbamazepine compared with phenytoin (time to treatment failure)
Population: adults and children with new‐onset focal or generalised epilepsy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Time to treatment failure (any reason related to treatment)All participants Range of Carbamazepine vs phenytoin (time to treatment failure) | HR 0.94 [0.7, 1.26] | 3 studies · 546 participants | Moderate Downgraded: risk of bias, indirectness |
Time to treatment failure (any reason related to treatment) Subgroup: focal onset seizures Range of Carbamazepine vs phenytoin (time to treatment failure) | HR 0.83 [0.61, 1.13] | 3 studies · 428 participants | Moderate Downgraded: risk of bias, indirectness |
Time to treatment failure (any reason related to treatment) Subgroup: generalisedonset tonic clonic seizures Range of Carbamazepine vs phenytoin (time to treatment failure) | HR 2.38 [1.04, 5.47] | 2 studies · 118 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Carbamazepine compared with phenytoin (secondary outcomes)
Population: adults and children with new‐onset focal or generalised epilepsy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Time to first seizure after randomisationAll participants Range of Carbamazepine vs phenytoin (secondary outcomes) | HR 1.15 [0.94, 1.4] | 4 studies · 582 participants | Moderate Downgraded: risk of bias |
Time to first seizure after randomisation Subgroup: focal onset seizures Range of Carbamazepine vs phenytoin (secondary outcomes) | HR 1.13 [0.89, 1.43] | 4 studies · 432 participants | Moderate Downgraded: risk of bias |
Time to first seizure after randomisationSubgroup: generalisedonset tonic clonic seizures Range of Carbamazepine vs phenytoin (secondary outcomes) | HR 1.19 [0.81, 1.75] | 3 studies · 150 participants | Low Downgraded: risk of bias, inconsistency |
Time to achieve 12‐month remissionAll participants Range of Carbamazepine vs phenytoin (secondary outcomes) | HR 1 [0.79, 1.26] | 3 studies · 551 participants | Moderate Downgraded: risk of bias |
Time to achieve 12‐month remissionSubgroup: focal onset seizures Range of Carbamazepine vs phenytoin (secondary outcomes) | HR 1.06 [0.8, 1.42] | 3 studies · 430 participants | Moderate Downgraded: risk of bias |
Time to achieve 12‐month remissionSubgroup: generalisedonset tonic clonic seizures Range of Carbamazepine vs phenytoin (secondary outcomes) | HR 0.88 [0.58, 1.33] | 2 studies · 121 participants | Low Downgraded: risk of bias, inconsistency |
Summary of findings ‐ Time to withdrawal of allocated treatment
Population: adults and children with new‐onset partial or generalised epilepsy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Time to withdrawal of allocated treatment ‐ stratified by epilepsy type Range of | HR 1.04 [0.78, 1.39] | 3 studies · 546 participants | Moderate Downgraded: risk of bias, indirectness |
Time to withdrawal of allocated treatment ‐ partial epilepsy Range of | HR 1.18 [0.87, 1.6] | 3 studies · 428 participants | Moderate Downgraded: risk of bias, indirectness |
Time to withdrawal of allocated treatment ‐ generalised epilepsy Range of | HR 0.42 [0.18, 0.96] | 2 studies · 118 participants | Moderate Downgraded: risk of bias, indirectness |
Proportion of withdrawals due to adverse effects Range of | RR 1.42 [1.13, 1.8] | 3 studies · 546 participants | Moderate Downgraded: risk of bias |
Summary of findings ‐ Time to 12‐ and 6‐month remission of seizures
Population: adults and children with new‐onset partial or generalised epilepsy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Time to 12‐month remission ‐ stratified by epilepsy type Range of | HR 1.01 [0.78, 1.31] | 3 studies · 551 participants | Moderate Downgraded: risk of bias, indirectness |
Time to 12‐month remission ‐ partial epilepsy Range of | HR 0.94 [0.71, 1.25] | 3 studies · 430 participants | Moderate Downgraded: risk of bias, indirectness |
Time to 12‐month remission ‐ generalised epilepsy Range of | HR 1.174 [0.53, 2.57] | 2 studies · 121 participants | Low Downgraded: risk of bias, inconsistency, indirectness |
Time to 6‐month remission ‐ stratified by epilepsy type Range of | HR 1.11 [0.89, 1.37] | 3 studies · 551 participants | Moderate Downgraded: risk of bias, indirectness |
Time to 6‐month remission ‐ partial epilepsy Range of | HR 1.02 [0.79, 1.33] | 3 studies · 430 participants | Moderate Downgraded: risk of bias, indirectness |
Time to 6‐month remission ‐ generalised epilepsy Range of | HR 1.3 [0.89, 1.92] | 2 studies · 121 participants | Moderate Downgraded: risk of bias, indirectness |
Summary of findings ‐ Time to first seizure after randomisation
Population: adults and children with new‐onset partial or generalised epilepsy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Time to first seizure ‐ stratified by epilepsy type Range of | HR 0.85 [0.7, 1.04] | 4 studies · 582 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Time to first seizure ‐ partial epilepsy Range of | HR 0.86 [0.68, 1.08] | 4 studies · 432 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Time to first seizure ‐ generalised epilepsy Range of | HR 0.84 [0.57, 1.24] | 3 studies · 150 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Summary of findings ‐ time to withdrawal of allocated treatment
Population: adults and children with newly‐onset partial or generalised epilepsy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Time to withdrawal of allocated treatment ‐ stratified by epilepsy type Range of | HR 1.04 [0.78, 1.39] | 3 studies · 546 participants | Moderate Downgraded: risk of bias, indirectness |
Time to withdrawal of allocated treatment ‐ partial epilepsy Range of | HR 1.18 [0.87, 1.6] | 3 studies · 428 participants | Moderate Downgraded: risk of bias, indirectness |
Time to withdrawal of allocated treatment ‐ generalised epilepsy Range of | HR 0.42 [0.18, 0.96] | 3 studies · 118 participants | Moderate Downgraded: risk of bias, indirectness |
Proportion of withdrawals due to adverse effects Range of | RR 1.42 [1.13, 1.8] | 3 studies · 546 participants | Moderate Downgraded: risk of bias |
Summary of findings ‐ time to 12 and 6 month remission of seizures
Population: adults and children with newly‐onset partial or generalised epilepsy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Time to 12‐month remission ‐ stratified by epilepsy type Range of | HR 1.01 [0.78, 1.31] | 3 studies · 551 participants | Moderate Downgraded: risk of bias, indirectness |
Time to 12‐month remission ‐ partial epilepsy Range of | HR 0.94 [0.71, 1.25] | 3 studies · 430 participants | Moderate Downgraded: risk of bias, indirectness |
Time to 12‐month remission ‐ generalised epilepsy Range of | HR 1.174 [0.53, 2.57] | 3 studies · 121 participants | Low Downgraded: risk of bias, inconsistency, indirectness |
Time to 6‐month remission ‐ stratified by epilepsy type Range of | HR 1.11 [0.89, 1.37] | 3 studies · 551 participants | Moderate Downgraded: risk of bias, indirectness |
Time to 6‐month remission ‐ partial epilepsy Range of | HR 1.02 [0.79, 1.33] | 3 studies · 430 participants | Moderate Downgraded: risk of bias, indirectness |
Time to 6‐month remission ‐ generalised epilepsy Range of | HR 1.3 [0.89, 1.92] | 3 studies · 121 participants | Moderate Downgraded: risk of bias, indirectness |
Summary of findings ‐ time to first seizure after randomisation
Population: adults and children with newly‐onset partial or generalised epilepsy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Time to first seizure ‐ stratified by epilepsy type Range of | HR 0.85 [0.7, 1.04] | 4 studies · 582 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Time to first seizure ‐ partial epilepsy Range of | HR 0.86 [0.68, 1.08] | 4 studies · 432 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Time to first seizure ‐ generalised epilepsy Range of | HR 0.84 [0.57, 1.24] | 4 studies · 150 participants | Low Downgraded: risk of bias, imprecision, indirectness |