Summary of findings 3. Ethosuximide compared to lamotrigine for absence seizures in children and adolescents.

Ethosuximide compared to lamotrigine for absence seizures in children and adolescents
Patient or population: absence seizures in children and adolescents Setting: outpatients Intervention: ethosuximide Comparison: lamotrigine
Outcomes	Anticipated absolute effects* (95% CI)		Relative effect (95% CI)	№ of participants (studies)	Certainty of the evidence (GRADE)	Comments
	Risk with lamotrigine	Risk with ethosuximide
Seizure freedom at 12 months	Study population		RR 0.47 (0.33 to 0.67)	300 (1 RCT)	⊕⊕⊕⊕ HIGH	Length of follow‐up: 12 months.
	455 per 1,000	214 per 1,000 (150 to 305)
80% or greater reduction in seizure frequency ‐ not reported	‐	‐	‐	‐	‐
50% or greater reduction in seizure frequency ‐ not reported	‐	‐	‐	‐	‐
Normalisation of the EEG ‐ not reported	‐	‐	‐	‐	‐
Adverse effects (Table 3; Table 5) Ethosuximide treatment was mostly associated with nausea, vomiting, and behavioural/psychiatric changes. The most common adverse effects of treatment with lamotrigine were fatigue, and behavioural/psychiatric changes.
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio
GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited; the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate; the true effect is likely to be substantially different from the estimate of effect.