Cochrane · systematic review · CD007144
Immediate antiepileptic drug treatment, versus placebo, deferred, or no treatment for first unprovoked seizure
Leone, MA, Giussani, G, Nevitt, SJ, et al. · Cochrane Database of Systematic Reviews · 2021 · 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
8
current version
GRADE rated
8
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 0 · 0%Low 1 · 12.5%Moderate 2 · 25%High 5 · 62.5%
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 onlyImmediate treatment compared to controls for first unprovoked seizure: seizure recurrence
Population: patients with first unprovoked seizure
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Seizure recurrence at 5 years after randomisation Immediate treatment vs controls | RR 0.78 [0.68, 0.89] | 2 studies · 1212 participants | High |
Five‐year immediate remission after randomisation Immediate treatment vs controls | RR 1.25 [1.02, 1.54] | 2 studies · 1212 participants | High |
Five‐year remission at any time after randomisation Immediate treatment vs controls | RR 1.02 [0.87, 1.21] | 2 studies · 1212 participants | High |
Seizure recurrence at 1 year after randomisation Immediate treatment vs controls | RR 0.49 [0.42, 0.58] | 6 studies · 1634 participants | High |
Mortality at the end of the Immediate treatment vs controls | RR 1.16 [0.69, 1.95] | 2 studies · 1212 participants | High |
Adverse events (control ‐ deferred treatment) Immediate treatment vs controls | RR 1.49 [1.23, 1.79] | 2 studies · 1212 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Adverse events (control ‐ no treatment) Immediate treatment vs controls | RR 14.5 [1.93, 108.76] | 1 study · 118 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Adverse events (control ‐ placebo) Immediate treatment vs controls | RR 4.91 [1.1, 21.93] | 1 study · 228 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Immediate treatment compared to controls for first unprovoked seizure
Population: patients with first unprovoked seizure
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Seizure recurrence at 5 years after randomisation Immediate treatment vs controls | RR 0.78 [0.68, 0.89] | 2 studies · 1212 participants | High |
Five year immediate remission after randomisation Immediate treatment vs controls | RR 1.25 [1.02, 1.54] | 2 studies · 1212 participants | High |
Five year remission at any time after randomisation Immediate treatment vs controls | RR 1.02 [0.87, 1.21] | 2 studies · 1212 participants | High |
Seizure recurrence at 1 year after randomisation Immediate treatment vs controls | RR 0.49 [0.42, 0.58] | 6 studies · 1634 participants | High |
Mortality at the end of the Immediate treatment vs controls | RR 1.16 [0.69, 1.95] | 2 studies · 1212 participants | High |
Adverse events (control ‐ deferred treatment) Immediate treatment vs controls | RR 1.49 [1.23, 1.79] | 2 studies · 1212 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Adverse events (control ‐ no treatment) Immediate treatment vs controls | RR 14.5 [1.93, 108.76] | 1 study · 118 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Adverse events (control ‐ placebo) Immediate treatment vs controls | RR 4.91 [1.1, 21.93] | 1 study · 228 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness |