evidencegaps
Cochrane · systematic review · CD003615

Oxcarbazepine versus phenytoin monotherapy for epilepsy: an individual participant data review

Nevitt, SJ, Tudur Smith, C, Marson, AG · Cochrane Database of Systematic Reviews · 2018 · Cochrane Library

Epilepsy2 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
11
current version
GRADE rated
11
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 0 · 0%Low 2 · 18.2%Moderate 8 · 72.7%High 1 · 9.1%

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 only

Summary of findings: oxcarbazepine versus phenytoin (primary outcomes)

Population: adults and children with newly diagnosed epilepsy
CD003615.PUB4 (current) · 5 questions
OutcomeEffectEvidenceStatus / GRADE
Time to treatment failure (any reason related to treatment) All participants Range of
Summary of findings: oxcarbazepine vs phenytoin (primary outcomes)
HR 0.78 [0.53, 1.14]2 studies · 476 participantsModerate
Downgraded: risk of bias, imprecision, indirectness
Time to treatment failure (any reason related to treatment) Subgroup: focal onset seizures Range of
Summary of findings: oxcarbazepine vs phenytoin (primary outcomes)
HR 0.69 [0.43, 1.09]2 studies · 333 participantsModerate
Downgraded: risk of bias, imprecision, indirectness
Time to treatment failure (any reason related to treatment) Subgroup: generalised onset seizures Range of
Summary of findings: oxcarbazepine vs phenytoin (primary outcomes)
HR 1.03 [0.51, 2.08]2 studies · 143 participantsModerate
Downgraded: risk of bias, imprecision, indirectness
Time to treatment failure due to adverse events All participants Range of
Summary of findings: oxcarbazepine vs phenytoin (primary outcomes)
HR 0.22 [0.1, 0.51]2 studies · 480 participantsHigh
Time to treatment failure due to lack of efficacy All participants Range of
Summary of findings: oxcarbazepine vs phenytoin (primary outcomes)
HR 1.17 [0.31, 4.35]2 studies · 480 participantsModerate
Downgraded: risk of bias, imprecision, indirectness

Summary of findings: oxcarbazepine versus phenytoin (secondary outcomes)

Population: adults and children with newly diagnosed epilepsy
CD003615.PUB4 (current) · 6 questions
OutcomeEffectEvidenceStatus / GRADE
Time to first seizure (post‐randomisation) All participants Range of
Summary of findings: oxcarbazepine vs phenytoin (secondary outcomes)
HR 0.97 [0.75, 1.26]2 studies · 468 participantsModerate
Downgraded: risk of bias, indirectness
Time to first seizure (post‐randomisation) Subgroup: focal onset seizures Range of
Summary of findings: oxcarbazepine vs phenytoin (secondary outcomes)
HR 0.92 [0.68, 1.25]2 studies · 326 participantsModerate
Downgraded: risk of bias, indirectness
Time to first seizure (post‐randomisation) Subgroup: generalised onset seizures Range of
Summary of findings: oxcarbazepine vs phenytoin (secondary outcomes)
HR 1.11 [0.66, 1.86]2 studies · 142 participantsLow
Downgraded: risk of bias, indirectness
Time to achieve 12‐month remission (seizure‐free period) All participants Range of
Summary of findings: oxcarbazepine vs phenytoin (secondary outcomes)
HR 1.04 [0.77, 1.41]2 studies · 468 participantsModerate
Downgraded: risk of bias, indirectness
Time to achieve 12‐month remission (seizure‐free period) Subgroup: focal onset seizures Range of
Summary of findings: oxcarbazepine vs phenytoin (secondary outcomes)
HR 1.09 [0.75, 1.57]2 studies · 326 participantsModerate
Downgraded: risk of bias, indirectness
Time to achieve 12‐month remission (seizure‐free period) Subgroup: generalised onset seizures Range of
Summary of findings: oxcarbazepine vs phenytoin (secondary outcomes)
HR 0.94 [0.55, 1.62]2 studies · 142 participantsLow
Downgraded: risk of bias, indirectness

Comparison

Population: adults and children with newly diagnosed epilepsy
CD003615.PUB3 · 12 questions
OutcomeEffectEvidenceStatus / GRADE
Time to withdrawal of allocated treatment ‐ all participants 8‐week titration period then 48‐week maintenance period Total: 56 weeks (392 days)
HR 1.64 [1.06, 2.54]2 studies · 476 participantsModerate
Time to withdrawal of allocated treatment Stratified by epilepsy type ‐ partial epilepsy 8‐week titration period then 48‐week maintenance period Total: 56 weeks (392 days)
HR 1.95 [1.15, 3.33]2 studies · 333 participantsModerate
Time to withdrawal of allocated treatment Stratified by epilepsy type ‐ generalised epilepsy 8‐week titration period then 48‐week maintenance period Total: 56 weeks (392 days)
HR 1.16 [0.54, 2.46]2 studies · 143 participantsModerate
Time to achieve 6‐month remission ‐ all participants 8‐week titration period then 48‐week maintenance period Total: 56 weeks (392 days)
HR 0.94 [0.74, 1.21]2 studies · 468 participantsModerate
Time to achieve 6‐month remission Stratified by epilepsy type ‐ partial epilepsy 8‐week titration period then 48‐week maintenance period Total: 56 weeks (392 days)
HR 0.85 [0.63, 1.15]2 studies · 326 participantsModerate
Time to achieve 6‐month remission Stratified by epilepsy type ‐ generalised epilepsy 8‐week titration period then 48‐week maintenance period Total: 56 weeks (392 days)
HR 1.2 [0.76, 1.89]2 studies · 142 participantsModerate
Time to achieve 12‐month remission ‐ all participants 8‐week titration period then 48‐week maintenance period Total: 56 weeks (392 days)
HR 0.95 [0.7, 1.29]2 studies · 468 participantsModerate
Time to achieve 12‐month remission Stratified by epilepsy type ‐ partial epilepsy 8‐week titration period then 48‐week maintenance period Total: 56 weeks (392 days)
HR 0.92 [0.64, 1.33]2 studies · 326 participantsModerate
Time to achieve 12‐month remission Stratified by epilepsy type ‐ generalised epilepsy 8‐week titration period then 48‐week maintenance period Total: 56 weeks (392 days)
HR 1.01 [0.59, 1.73]2 studies · 142 participantsModerate
Time to first seizure ‐ all participants 8‐week titration period then 48‐week maintenance period Total: 56 weeks (392 days)
HR 1.04 [0.8, 1.35]2 studies · 468 participantsModerate
Time to first seizure Stratified by epilepsy type ‐ partial epilepsy 8‐week titration period then 48‐week maintenance period Total: 56 weeks (392 days)
HR 1.08 [0.8, 1.47]2 studies · 326 participantsModerate
Time to first seizure Stratified by epilepsy type ‐ generalised epilepsy 8‐week titration period then 48‐week maintenance period Total: 56 weeks (392 days)
HR 0.94 [0.56, 1.56]2 studies · 142 participantsModerate