Methods | Parallel study design, outpatient setting Study conducted at two centres in the UK Random list generated using random permuted blocks Allocation concealed using sealed opaque envelopes Unblinded |
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Participants | Adults with newly diagnosed epilepsy (2 or more untreated partial or generalised tonic‐clonic seizures in the 12 months preceding the trial) Number randomised: PHT = 63; SV = 61 53 participants (43%) with partial epilepsy. 62 (48%) men Mean age (range): 33 (14‐72) years Range of follow‐up (months): 1‐91 |
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Interventions | Monotherapy with PHT or SV Median daily dose achieved: PHT: 300 mg/day, SV: 800 mg/day |
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Outcomes | Time to first seizure recurrence after start of therapy Time to 12‐month remission from all seizures Adverse events and withdrawal due to adverse events | |
Notes | IPD provided for all outcomes of this review | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Randomisation list generated using permuted blocks of size 8 or 16 with stratification for centre, seizure type and presence of neurological signs |
Allocation concealment (selection bias) | Low risk | Allocation concealed via 4 batches of concealed opaque envelopes |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Unblinded, authors state masking of treatment would not be “practical” and would have “introduced bias due to a very large drop‐out rate” |
Blinding of outcome assessment (detection bias) All outcomes | High risk | Unblinded, authors state masking of treatment would not be “practical” and would have “introduced bias due to a very large drop‐out rate” |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Attrition rates reported, all randomised participants analyses from IPD provided (see footnote 2) |
Selective reporting (reporting bias) | Low risk | All outcomes reported or calculated with IPD provided (see footnote 2) |
Other bias | Low risk | No other bias detected |