Table 13.
Pairwise and network meta‐analysis results ‐ Time to six‐month remission of seizures for individuals with generalised 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 | 3 | 158 | 0.56 (0.33 to 0.96) | 13.2% | 28.2% | 1.28 (0.92 to 1.79) |
| CBZ vs PHT | 2 | 121 | 1.44 (0.82 to 2.55) | 31.4% | 13% | 0.87 (0.68 to 1.10) |
| CBZ vs VPS | 4 | 412 | 1.11 (0.81 to 1.53) | 29.9% | 30.7% | 0.95 (0.84 to 1.09) |
| CBZ vs LTG | 5 | 254 | 0.58 (0.25 to 1.32) | 0% | 0.1% | 1.20 (0.99 to 1.49) |
| CBZ vs OXC | 1 | 9 | 0.79 (0.17 to 3.56) | NA | 4.6% | 1.30 (0.42 to 4.00) |
| CBZ vs TPM | 2 | 101 | 1.00 (0.55 to 1.79) | 0% | 32.8% | 1.11 (0.78 to 1.59) |
| CBZ vs GBP | 1 | 6 | 0.71 (0.07 to 6.90) | NA | 10% | 1.75 (0.23 to 12.5) |
| CBZ vs LEV | 2 | 251 | 1.00 (0.72 to 1.37) | 57.9% | 26.7% | 1.14 (0.85 to 1.52) |
| PHB vs PHT | 3 | 130 | 1.31 (0.67 to 2.53) | 0% | 22.7% | 0.68 (0.47 to 0.98) |
| PHB vs VPS | 2 | 98 | 1.50 (0.72 to 3.11) | 7.5% | 15.3% | 0.75 (0.53 to 1.05) |
| PHB vs LTG | No direct evidence | 0% | 0.94 (0.64 to 1.39) | |||
| PHB vs OXC | No direct evidence | 0% | 1.01 (0.31 to 3.23) | |||
| PHB vs TPM | No direct evidence | 0% | 0.87 (0.53 to 1.41) | |||
| PHB vs GBP | No direct evidence | 0% | 1.37 (0.17 to 11.1) | |||
| PHB vs LEV | No direct evidence | 0% | 0.88 (0.57 to 1.37) | |||
| PHT vs VPS | 4 | 394 | 1.03 (0.68 to 1.54) | 0% | 36.8% | 1.10 (0.85 to 1.43) |
| PHT vs LTG | 1 | 91 | 1.96 (0.37 to 10.2) | NA | 4.4% | 1.39 (1.03 to 1.89) |
| PHT vs OXC | 2 | 154 | 0.71 (0.42 to 1.21) | 0% | 45.1% | 1.49 (0.48 to 4.76) |
| PHT vs TPM | No direct evidence | 0% | 1.28 (0.84 to 1.96) | |||
| PHT vs GBP | No direct evidence | 0% | 2.00 (0.26 to 16.7) | |||
| PHT vs LEV | No direct evidence | 0% | 1.32 (0.89 to 1.92) | |||
| VPS vs LTG | 3 | 387 | 0.84 (0.48 to 1.47) | 0% | 43.5% | 1.27 (1.03 to 1.56) |
| VPS vs OXC | No direct evidence | 0% | 1.35 (0.44 to 4.17) | |||
| VPS vs TPM | 2 | 441 | 0.67 (0.38 to 1.19) | 58.7% | 12.9% | 1.16 (0.81 to 1.67) |
| VPS vs GBP | No direct evidence | 0% | 1.82 (0.24 to 14.3) | |||
| VPS vs LEV | 1 | 512 | 0.88 (0.60 to 1.30) | NA | 48.6% | 1.19 (0.86 to 1.64) |
| LTG vs OXC | 1 | 10 | 0.80 (0.20 to 3.26) | NA | 7.6% | 1.08 (0.35 to 3.33) |
| LTG vs TPM | 1 | 14 | 0.59 (0.30 to 1.16) | NA | 10% | 0.92 (0.62 to 1.37) |
| LTG vs GBP | 1 | 7 | 0.73 (0.08 to 6.57) | NA | 11% | 1.45 (0.19 to 11.1) |
| LTG vs LEV | No direct evidence | 0% | 0.93 (0.65 to 1.33) | |||
| OXC vs TPM | 1 | 14 | 1.34 (0.40 to 4.54) | NA | 9.4% | 0.86 (0.28 to 2.63) |
| OXC vs GBP | 1 | 7 | 0.91 (0.10 to 8.20) | NA | 10.7% | 1.35 (0.15 to 12.5) |
| OXC vs LEV | No direct evidence | 0% | 0.88 (0.27 to 2.78) | |||
| TPM vs GBP | 1 | 11 | 0.68 (0.08 to 5.45) | NA | 13.9% | 1.56 (0.21 to 12.5) |
| TPM vs LEV | No direct evidence | 0% | 1.02 (0.65 to 1.61) | |||
| GBP vs LEV | No direct evidence | 0% | 0.65 (0.08 to 5.00) | |||
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
Generalised tonic‐clonic seizures with or without other seizure types is shortened to 'Generalised seizures' for brevity
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.