| Study characteristics |
| Methods |
Randomised, double‐blind, placebo‐controlled, parallel‐group study
Allocation concealment using telephone randomisation
Random permuted blocks of 6 per participating centre
Blinded using identical tablets and packaging
12 week pre‐randomisation baseline period, 24‐week treatment period including 6‐week dose titration |
| Participants |
Multicentre study, 49 centres in Europe and 5 in South Africa
351 participants. At least 12 seizures during 12‐week baseline period, with no period of more than 3 weeks seizure‐free
Taking 1 to 3 AEDs
Aged 12 to 77
51% male |
| Interventions |
Placebo, 100 mg, 300 mg, or 500 mg placebo, randomised in 2:1:1:2 ratio |
| Outcomes |
Reduction in seizure frequency, proportion with a 50% or greater reduction in seizure frequency
Adverse events |
| Notes |
|
| Risk of bias |
| Bias |
Authors' judgement |
Support for judgement |
| Random sequence generation (selection bias) |
Low risk |
"Patients were randomised sequentially in blocks of six" |
| Allocation concealment (selection bias) |
Unclear risk |
Insufficient details were provided |
| Blinding of participants and personnel (performance bias)
All outcomes |
Low risk |
"Treatments were blinded using a double dummy technique throughout the study" |
| Blinding of outcome assessment (detection bias)
All outcomes |
Unclear risk |
Insufficient details about blinding of outcome assessors was provided |
| Incomplete outcome data (attrition bias)
All outcomes |
Low risk |
A modified ITT analysis was conducted as "all patients who received at least one dose of study drug were included in the safety analysis". 4 participants not included in the analysis were spread fairly evenly among groups (1 participant lost from 2 groups, 2 participants lost from 1 group) |
| Selective reporting (reporting bias) |
Low risk |
This study was deemed to be at a low risk of selective reporting |
| Funding Source |
Low risk |
Reported (sponsored by industry) |
| Conflicts of interest |
Unclear risk |
Not specified |
| Other bias |
Low risk |
Allocation to groups led to different durations of stable‐dose phase |