Table 8.
Pairwise and network meta‐analysis results ‐ Time to withdrawal of allocated treatment for individuals with partial seizures
| Comparisiona | Direct evidence (pairwise meta‐analysis) | Direct plus indirect evidence (network meta‐analysis) | ||||
| Number of studies | Number of participants | HR (95% CI)b,c | I² statisticd | Direct evidence (%)e | HR (95% CI)b,c | |
| CBZ vs PHB | 4 | 520 | 1.57 (1.16 to 2.13) | 0% | 52.5% | 1.55 (1.18 to 2.04) |
| CBZ vs PHT | 3 | 428 | 1.03 (0.74 to 1.42) | 63.6% | 12.8% | 1.13 (0.92 to 1.38) |
| CBZ vs VPS | 5 | 814 | 0.94 (0.73 to 1.19) | 0% | 40.1% | 1.04 (0.86 to 1.25) |
| CBZ vs LTG | 9 | 2268 | 0.76 (0.61 to 0.95) | 39.3% | 28.9% | 0.75 (0.65 to 0.86) |
| CBZ vs OXC | 2 | 562 | 4.62 (0.95 to 22.4) | 0% | 5.7% | 1.09 (0.84 to 1.42) |
| CBZ vs TPM | 2 | 937 | 1.04 (0.52 to 2.07) | 0% | 7.4% | 1.18 (0.98 to 1.43) |
| CBZ vs GBP | 2 | 954 | 1.14 (0.84 to 1.55) | 0% | 87.1% | 1.20 (1.00 to 1.43) |
| CBZ vs LEV | 3 | 1567 | 0.70 (0.52 to 0.94) | 0% | 37.9% | 0.82 (0.69 to 0.97) |
| CBZ vs ZNS | 1 | 583 | 1.08 (0.81 to 1.44) | NA | 100% | 1.08 (0.79 to 1.48) |
| PHB vs PHT | 3 | 404 | 0.67 (0.50 to 0.91) | 65% | 15.2% | 0.73 (0.55 to 0.96) |
| PHB vs VPS | 2 | 75 | 0.68 (0.34 to 1.36) | 23% | 8.8% | 0.67 (0.48 to 0.92) |
| PHB vs LTG | No direct evidence | 0% | 0.48 (0.35 to 0.66) | |||
| PHB vs OXC | No direct evidence | 0% | 0.70 (0.48 to 1.03) | |||
| PHB vs TPM | No direct evidence | 0% | 0.76 (0.55 to 1.06) | |||
| PHB vs GBP | No direct evidence | 0% | 0.77 (0.55 to 1.07) | |||
| PHB vs LEV | No direct evidence | 0% | 0.53 (0.38 to 0.73) | |||
| PHB vs ZNS | No direct evidence | 0% | 0.70 (0.46 to 1.06) | |||
| PHT vs VPS | 4 | 168 | 1.00 (0.60 to 1.64) | 58.5% | 9% | 0.92 (0.70 to 1.21) |
| PHT vs LTG | 1 | 90 | 1.10 (0.57 to 2.14) | NA | 11.6% | 0.66 (0.52 to 0.85) |
| PHT vs OXC | 2 | 325 | 0.65 (0.32 to 1.32) | 0% | 40.4% | 0.97 (0.69 to 1.35) |
| PHT vs TPM | 1 | 53 | 0.77 (0.38 to 1.57) | NA | 10.9% | 1.05 (0.80 to 1.39) |
| PHT vs GBP | No direct evidence | 0% | 1.06 (0.81 to 1.40) | |||
| PHT vs LEV | No direct evidence | 0% | 0.73 (0.56 to 0.95) | |||
| PHT vs ZNS | No direct evidence | 0% | 0.96 (0.66 to 1.39) | |||
| VPS vs LTG* | 3 | 221 | 1.40 (1.00 to 1.96) | 45.1% | 5.1% | 0.72 (0.58 to 0.90) |
| VPS vs OXC | No direct evidence | 0% | 1.05 (0.76 to 1.44) | |||
| VPS vs TPM | 2 | 111 | 1.66 (1.24 to 2.23) | 48.1% | 33.7% | 1.14 (0.88 to 1.48) |
| VPS vs GBP | No direct evidence | 0% | 1.15 (0.89 to 1.49) | |||
| VPS vs LEV | 1 | 190 | 1.14 (0.73 to 1.75) | NA | 17.2% | 0.79 (0.61 to 1.03) |
| VPS vs ZNS | No direct evidence | 0% | 1.04 (0.73 to 1.50) | |||
| LTG vs OXC | 1 | 506 | 0.69 (0.12 to 4.14) | NA | 4.4% | 1.46 (1.11 to 1.92) |
| LTG vs TPM | 1 | 648 | 1.18 (0.86 to 1.62) | NA | 20.9% | 1.59 (1.29 to 1.95) |
| LTG vs GBP | 1 | 659 | 0.62 (0.06 to 6.01) | NA | 1% | 1.60 (1.31 to 1.96) |
| LTG vs LEV | 1 | 240 | 0.86 (0.58 to 1.28) | NA | 23.7% | 1.10 (0.89 to 1.35) |
| LTG vs ZNS | No direct evidence | 0% | 1.45 (1.03 to 2.04) | |||
| OXC vs TPM | 1 | 496 | 0.87 (0.16 to 4.73) | NA | 4.9% | 1.09 (0.82 to 1.44) |
| OXC vs GBP | 1 | 507 | 0.90 (0.08 to 9.96) | NA | 2.3% | 1.10 (0.83 to 1.45) |
| OXC vs LEV | No direct evidence | 0% | 0.75 (0.55 to 1.03) | |||
| OXC vs ZNS | No direct evidence | 0% | 0.99 (0.66 to 1.49) | |||
| TPM vs GBP | 1 | 649 | 1.04 (0.12 to 9.33) | NA | 1.1% | 1.01 (0.82 to 1.25) |
| TPM vs LEV | No direct evidence | 0% | 0.69 (0.54 to 0.89) | |||
| TPM vs ZNS | No direct evidence | 0% | 0.91 (0.64 to 1.31) | |||
| GBP vs LEV | No direct evidence | 0% | 0.69 (0.54 to 0.88) | |||
| GBP vs ZNS | No direct evidence | 0% | 0.90 (0.63 to 1.30) | |||
| LEV vs ZNS | No direct evidence | 0% | 1.32 (0.93 to 1.88) | |||
CBZ: carbamazepine; CI: confidence interval; GBP: gabapentin; HR: hazard ratio; LEV: levetiracetam; LTG: lamotrigine; OXC: oxcarbazepine; PHB: phenobarbitone; PHT: phenytoin; TPM: topiramate; VPS: sodium valproate; ZNS: zonisamide
aOrder of drugs in the table: most commonly used drug first (carbamazepine), then drugs are ordered approximately by the date they were licenced as a monotherapy treatment (oldest first). bHRs and 95% CIs are calculated from fixed‐effect analyses (pairwise and network meta‐analysis); where substantial heterogeneity was present (I2 > 50%), random‐effects meta‐analysis was also conducted, see Effects of interventions for further details. cNote that HR < 1 indicates an advantage to the second drug in the comparison; results highlighted in bold are statistically significant. dNA ‐ heterogeneity is not applicable as only one study contributed direct evidence. eDirect evidence (%) ‐ proportion of the estimate contributed by direct evidence.
For comparisons marked with a *, confidence intervals of direct evidence and network meta‐analysis do not overlap indicating that inconsistency may be present in the results.