evidencegaps
Cochrane · systematic review · CD012065

Topiramate versus carbamazepine monotherapy for epilepsy: an individual participant data review

Nevitt, SJ, Sudell, M, Tudur Smith, C, et al. · Cochrane Database of Systematic Reviews · 2019 · 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
9
current version
GRADE rated
9
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 0 · 0%Low 1 · 11.1%Moderate 4 · 44.4%High 4 · 44.4%

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

Topiramate compared with carbamazepine for epilepsy (time to treatment failure)

Population: adults and children with newly onset focal or generalised epilepsy
CD012065.PUB3 (current) · 3 questions
OutcomeEffectEvidenceStatus / GRADE
Time to treatment failure (any reason related to treatment) All participants ‐ adjusted by seizure type Range of
Topiramate vs carbamazepine
HR 1.16 [0.97, 1.38]2 studies · 1129 participantsModerate
Downgraded: risk of bias
Time to treatment failure (any reason related to treatment)Subgroup: focal onset seizures Range of
Topiramate vs carbamazepine
HR 1.21 [1.01, 1.46]2 studies · 937 participantsModerate
Downgraded: risk of bias
Time to treatment failure (any reason related to treatment) Subgroup: generalised onset tonic‐clonic seizures or unclassified epilepsy Range of
Topiramate vs carbamazepine
HR 0.88 [0.56, 1.39]2 studies · 192 participantsLow
Downgraded: imprecision, indirectness

Topiramate compared with carbamazepine for epilepsy (secondary outcomes)

Population: adults and children with newly onset focal or generalised epilepsy
CD012065.PUB3 (current) · 6 questions
OutcomeEffectEvidenceStatus / GRADE
Time to first seizure after randomisation All participants Range of
Topiramate vs carbamazepine
HR 1.11 [0.96, 1.29]2 studies · 1115 participantsHigh
Time to first seizure after randomisation Subgroup: focal onset seizures Range of
Topiramate vs carbamazepine
HR 1.12 [0.95, 1.31]2 studies · 925 participantsHigh
Time to first seizure after randomisation Subgroup: generalised onset tonic‐clonic seizures or unclassified epilepsy Range of
Topiramate vs carbamazepine
HR 1.08 [0.7, 1.66]2 studies · 190 participantsModerate
Downgraded: imprecision, indirectness
Time to 12‐month remission of seizures All participants Range of
Topiramate vs carbamazepine
HR 0.84 [0.71, 0.99]2 studies · 1115 participantsHigh
Time to 12‐month remission of seizures Subgroup: focal onset seizures Range of
Topiramate vs carbamazepine
HR 0.82 [0.69, 0.99]2 studies · 925 participantsHigh
Time to 12‐month remission of seizures Subgroup: generalised onset tonic‐clonic seizures or unclassified epilepsy Range of
Topiramate vs carbamazepine
HR 0.92 [0.61, 1.41]2 studies · 190 participantsModerate
Downgraded: imprecision, indirectness

Comparison

Population: Adults and children with epilepsy
CD012065.PUB2 · 3 questions
OutcomeEffectEvidenceStatus / GRADE
Time to treatment withdrawal (adjusted for epilepsy type) Range of
HR 1.16 [0.98, 1.38]2 studies · 1129 participantsModerate
Downgraded: risk of bias, imprecision, indirectness
Time to treatment withdrawal ‐ stratified by epilepsy type ‐ partial onset Range of
HR 1.2 [1, 1.45]2 studies · 974 participantsModerate
Downgraded: risk of bias, imprecision, indirectness
Time to treatment withdrawal ‐ stratified by epilepsy type ‐ generalised‐onset or unclassified epilepsy Range of
HR 0.9 [0.54, 1.47]2 studies · 155 participantsLow
Downgraded: risk of bias, imprecision, indirectness

Comparison

Population: Adults and children with epilepsy
CD012065.PUB2 · 6 questions
OutcomeEffectEvidenceStatus / GRADE
Time to first seizure after randomisation ‐ stratified by epilepsy type Range of
HR 1.11 [0.96, 1.29]2 studies · 1129 participantsHigh
Time to first seizure after randomisation ‐ stratified by epilepsy type ‐ partial onset Range of
HR 1.12 [0.96, 1.31]2 studies · 962 participantsHigh
Time to first seizure after randomisation ‐ stratified by epilepsy type ‐ generalised‐onset or unclassified epilepsy Range of
HR 1.07 [0.69, 1.67]2 studies · 153 participantsModerate
Downgraded: imprecision, indirectness
Time to 12‐month remission of seizures ‐ stratified by epilepsy type Range of
HR 0.84 [0.71, 1]2 studies · 1129 participantsHigh
Time to 12‐month remission of seizures ‐ stratified by epilepsy type ‐ partial onset Range of
HR 0.83 [0.69, 1]2 studies · 962 participantsHigh
Time to 12‐month remission of seizures ‐ stratified by epilepsy type ‐ generalised‐onset or unclassified epilepsy Range of
HR 0.91 [0.58, 1.43]2 studies · 153 participantsModerate
Downgraded: imprecision, indirectness