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. 2019 Oct 23;2019(10):CD001417. doi: 10.1002/14651858.CD001417.pub4

Privitera 1996.

Methods Double‐blind, parallel‐group study
 4 treatment arms: 1 placebo, 3 topiramate
 Pre‐randomisation baseline period: 12 weeks
 Treatment period: 18 weeks
Participants A multicentre study (USA)
 190 people were randomised (all with drug‐resistant focal epilepsy): 47 to placebo, 48 to 600 mg topiramate, 48 to 800 mg topiramate, 47 to 1000 mg topiramate
 Age range: 18 to 68 years
Mean age: 35.5 years
80% males
 Other AEDs: 2 or fewer
 Median baseline monthly seizure frequency: 11 (9.3 for placebo group, 10.0 for 600 mg/d topiramate group, 16.2 for 800 mg/d topiramate group, 11.7 for 1000 mg/d topiramate group)
Interventions 600 mg topiramate per day or 800 mg topiramate per day or 1000 mg topiramate per day or placebo
Outcomes
  1. Percentage seizure rate reduction

  2. Percentage responders (≥ 50%)

  3. Adverse effects

Notes Trial sponsored by Johnson & Johnson
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Comment: random permuted blocks
Allocation concealment (selection bias) Low risk Comment: sealed, numbered packages allocated sequentially
Blinding (performance bias and detection bias) 
 All outcomes Low risk Quote: "topiramate and placebo tablets were identical in appearance and packaging"
Blinding of participants and personnel (performance bias) 
 All outcomes Low risk Comment: it is likely that blinding was maintained
Blinding of outcome assessment (detection bias) 
 All outcomes Unclear risk Comment: specific details of outcome assessment blinding not provided
Incomplete outcome data (attrition bias) 
 All outcomes Low risk Quote: "all 209 subjects who enrolled in the double‐blind phase of the trial were included in the efficacy analysis"
Selective reporting (reporting bias) Low risk Comment: data published in full according to the protocol
Other bias Low risk Comment: the study appears to be free of other sources of bias