Summary of findings 2.
| Topiramate compared with carbamazepine for epilepsy | ||||||
|
Population: Adults and children with epilepsy Settings: Outpatients Intervention: Topiramate Comparison: Carbamazepine | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No. of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Carbamazepine | Topiramate | |||||
|
Time to first seizure after randomisation ‐ stratified by epilepsy type Range of follow up: 0 to 2420 days |
646 per 1000 | 684 per 1000 (631 to 738) |
HR: 1.11 (0.96 to 1.29) |
1129 (2 studies) |
⊕⊕⊕⊕ high | HR > 1 indicates a clinical advantage for topiramate |
|
Time to first seizure after randomisation ‐ stratified by epilepsy type ‐ partial onset Range of follow up: 0 to 2420 days |
660 per 1000 | 702 per 1000 (645 to 756) |
HR: 1.12 (0.96 to 1.31) |
962 (2 studies) |
⊕⊕⊕⊕ high | HR > 1 indicates a clinical advantage for topiramate |
|
Time to first seizure after randomisation ‐ stratified by epilepsy type ‐ generalised‐onset or unclassified epilepsy Range of follow up: 0 to 853 days |
542 per 1000 | 567 per 1000 (417 to 729) |
HR: 1.07 (0.69 to 1.67) |
153 (2 studies) |
⊕⊕⊕⊝ moderate1 | HR > 1 indicates a clinical advantage for topiramate |
|
Time to 12‐month remission of seizures ‐ stratified by epilepsy type Range of follow up: 0 to 2420 days |
572 per 1000 | 510 per 1000 (453 to 572) |
HR: 0.84 (0.71 to 1.00) |
1129 (2 studies) |
⊕⊕⊕⊕ high | HR > 1 indicates a clinical advantage for carbamazepine |
|
Time to 12‐month remission of seizures ‐ stratified by epilepsy type ‐ partial onset Range of follow up: 0 to 2420 days |
574 per 1000 | 508 per 1000 (445 to 574) |
HR: 0.83 (0.69 to 1.00) |
962 (2 studies) |
⊕⊕⊕⊕ high | HR > 1 indicates a clinical advantage for carbamazepine |
|
Time to 12‐month remission of seizures ‐ stratified by epilepsy type ‐ generalised‐onset or unclassified epilepsy Range of follow up: 0 to 853 days |
559 per 1000 | 526 per 1000 (378 to 690) |
HR: 0.91 (0.58 to 1.43) |
153 (2 studies) |
⊕⊕⊕⊝ moderate1 | HR > 1 indicates a clinical advantage for carbamazepine |
| The assumed risk is calculated as the event rate in the carbamazepine treatment. The corresponding risk (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). The corresponding risk is calculated as the assumed risk x the relative risk (RR) of the intervention where RR = (1 ‐ exp(HR x ln(1 ‐ assumed risk)))/assumed risk. CI: Confidence interval; HR: Hazard Ratio; | ||||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||
1. Downgraded once for imprecision and applicability, limited information on generalised seizure types and most participants do not have a classified seizure type in this subgroup so the interpretation of this seizure type is unclear.