| Methods | Randomized open‐label observational study | |
| Participants | 33 participants with juvenile myoclonic epilepsy | |
| Interventions | Participants were assigned as 1:1 ratio to topiramate (16 participants) or valproate (17 participants) for 32 weeks. The assigned antiepileptic drug was titrated up to 1200 mg/day for valproate or 100 mg/day for topiramate. The dose of valproate was titrated up 300 mg/day for 2 weeks, whereas topiramate was increased 25 mg/day for 2 weeks. In participants with a poor response to medication during the 24‐week maintenance phase, the dose of valproate was increased 300 mg/day for 1 month to a maximum dose of 2400 mg/day, and the dose of topiramate was increased 50 mg/day for 1 month to a maximum 300 mg/day | |
| Outcomes | Number of days without myoclonic seizures during the 24‐week maintenance period, adverse events | |
| Notes | Baseline period was not clear. An 8‐week titration phase was followed by a 24‐week maintenance phase | |
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Participants underwent computerized randomization in a 1 : 1 ratio to primary treatment with topiramate or valproate |
| Allocation concealment (selection bias) | Unclear risk | Not reported |
| Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | Not reported |
| Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Not reported |
| Incomplete outcome data (attrition bias) All outcomes | High risk | 1 (6%) participant who was randomized to topiramate was removed from the study due to severe anorexia. 4 (25%) participants from the topiramate group and 1 (6%) participant from the valproate group were lost to follow‐up |
| Selective reporting (reporting bias) | Unclear risk | No pre published protocol |
| Other bias | Low risk | No other bias was found |
PGTCS: primarily generalized tonic‐clonic seizures.