Table 14.
Pairwise and network meta‐analysis results ‐ Time to first seizure 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 | 6 | 581 | 0.99 (0.78 to 1.26) | 54.3% | 21% | 0.79 (0.64 to 0.97) |
| CBZ vs PHT | 4 | 432 | 0.91 (0.72 to 1.16) | 16.1% | 27.1% | 0.98 (0.85 to 1.13) |
| CBZ vs VPS | 5 | 813 | 1.01 (0.86 to 1.19) | 32% | 34.6% | 1.20 (1.06 to 1.37) |
| CBZ vs LTG | 9 | 2252 | 0.98 (0.75 to 1.27) | 0% | 40.7% | 1.29 (1.17 to 1.42) |
| CBZ vs OXC | 2 | 555 | 1.47 (0.57 to 3.81) | 57.3% | 4.8% | 1.09 (0.89 to 1.32) |
| CBZ vs TPM | 2 | 925 | 1.03 (0.51 to 2.08) | 69.3% | 1.5% | 1.12 (0.97 to 1.29) |
| CBZ vs GBP | 2 | 943 | 1.64 (1.14 to 2.36) | 17.7% | 49% | 1.44 (1.25 to 1.66) |
| CBZ vs LEV | 3 | 1552 | 1.18 (0.85 to 1.65) | 0% | 26.2% | 1.14 (0.99 to 1.30) |
| CBZ vs ZNS | 1 | 581 | 1.30 (0.97 to 1.73) | NA | 100% | 1.30 (0.97 to 1.73) |
| PHB vs PHT | 5 | 463 | 1.07 (0.83 to 1.37) | 27.7% | 33.6% | 1.24 (0.99 to 1.56) |
| PHB vs VPS* | 2 | 80 | 0.71 (0.43 to 1.17) | 9.1% | 12.8% | 1.53 (1.20 to 1.94) |
| PHB vs LTG | No direct evidence | 0% | 1.63 (1.30 to 2.06) | |||
| PHB vs OXC | No direct evidence | 0% | 1.38 (1.04 to 1.83) | |||
| PHB vs TPM | No direct evidence | 0% | 1.42 (1.11 to 1.83) | |||
| PHB vs GBP | No direct evidence | 0% | 1.83 (1.42 to 2.35) | |||
| PHB vs LEV | No direct evidence | 0% | 1.44 (1.12 to 1.85) | |||
| PHB vs ZNS | No direct evidence | 0% | 1.64 (1.15 to 2.35) | |||
| PHT vs VPS | 5 | 245 | 0.96 (0.72 to 1.29) | 0% | 25.4% | 1.23 (1.02 to 1.48) |
| PHT vs LTG | 1 | 90 | 0.77 (0.38 to 1.54) | NA | 6% | 1.31 (1.10 to 1.57) |
| PHT vs OXC | 2 | 318 | 1.46 (0.88 to 2.44) | 23.9% | 36.1% | 1.11 (0.87 to 1.41) |
| PHT vs TPM | 1 | 53 | 2.32 (0.95 to 5.70) | NA | 4% | 1.14 (0.93 to 1.40) |
| PHT vs GBP | No direct evidence | 0% | 1.47 (1.20 to 1.80) | |||
| PHT vs LEV | No direct evidence | 0% | 1.16 (0.95 to 1.41) | |||
| PHT vs ZNS | No direct evidence | 0% | 1.32 (0.96 to 1.82) | |||
| VPS vs LTG | 3 | 215 | 1.57 (1.23 to 2.00) | 39.4% | 10% | 1.07 (0.92 to 1.24) |
| VPS vs OXC | No direct evidence | 0% | 0.90 (0.72 to 1.14) | |||
| VPS vs TPM | 2 | 111 | 1.18 (0.93 to 1.50) | 0% | 70.2% | 0.93 (0.77 to 1.13) |
| VPS vs GBP | No direct evidence | 0% | 1.20 (0.99 to 1.44) | |||
| VPS vs LEV | 1 | 190 | 1.27 (0.94 to 1.72) | NA | 31% | 0.94 (0.77 to 1.15) |
| VPS vs ZNS | No direct evidence | 0% | 1.08 (0.78 to 1.48) | |||
| LTG vs OXC | 1 | 499 | 0.87 (0.23 to 3.25) | NA | 5.5% | 0.84 (0.69 to 1.03) |
| LTG vs TPM | 1 | 636 | 0.73 (0.57 to 0.93) | NA | 2.3% | 0.87 (0.75 to 1.01) |
| LTG vs GBP | 1 | 647 | 0.63 (0.07 to 5.42) | NA | 4.4% | 1.12 (0.96 to 1.30) |
| LTG vs LEV | 1 | 229 | 0.84 (0.53 to 1.35) | NA | 15.9% | 0.88 (0.75 to 1.04) |
| LTG vs ZNS | No direct evidence | 0% | 1.01 (0.74 to 1.36) | |||
| OXC vs TPM | 1 | 487 | 0.55 (0.15 to 2.06) | NA | 5.4% | 1.03 (0.84 to 1.27) |
| OXC vs GBP | 1 | 498 | 0.73 (0.08 to 6.49) | NA | 4.6% | 1.32 (1.08 to 1.63) |
| OXC vs LEV | No direct evidence | 0% | 1.05 (0.83 to 1.32) | |||
| OXC vs ZNS | No direct evidence | 0% | 1.19 (0.84 to 1.69) | |||
| TPM vs GBP | 1 | 635 | 1.31 (0.15 to 11.2) | NA | 3.5% | 1.28 (1.09 to 1.51) |
| TPM vs LEV | No direct evidence | 0% | 1.01 (0.83 to 1.23) | |||
| TPM vs ZNS | No direct evidence | 0% | 1.15 (0.84 to 1.59) | |||
| GBP vs LEV | No direct evidence | 0% | 0.79 (0.65 to 0.96) | |||
| GBP vs ZNS | No direct evidence | 0% | 0.90 (0.65 to 1.24) | |||
| LEV vs ZNS | No direct evidence | 0% | 1.14 (0.83 to 1.57) | |||
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.