XXXX versus @entity109 monotherapy for epilepsy.

@entity1 @entity2049 @entity410 @entity109
BACKGROUND: In developing countries, @entity109 is commonly used but its use in Europe and the USA has decreased due to concerns over adverse effects. @entity2049 is recommended as the drug of choice for partial onset @entity410 , and there is concern that it may worsen some generalized onset @entity410 types. We report a review using individual @entity1 data in which @entity2049 and @entity109 are compared. OBJECTIVES: To review the effects of @entity2049 compared to @entity109 monotherapy for @entity1 with partial onset @entity410 or generalized onset @entity410 . SEARCH STRATEGY: The Cochrane Controlled trials register (Cochrane Library Issue 2, 2002); MEDLINE; EMBASE; handsearching; contacting experts and original trial investigators; contacting manufacturers of @entity2049 . SELECTION CRITERIA: Randomized or quasi-randomized, blinded or unblinded controlled trials in @entity1 or adults with partial onset @entity410 or generalized onset @entity410 . DATA COLLECTION AND ANALYSIS: Outcome measures were (i) time to withdrawal of allocated treatment, (ii) time to 12 month remission, and (iii) time to first @entity410 . Data were analysed using a stratified logrank analysis with results expressed as hazard ratios (HR) and 95% confidence intervals (CIs), where a HR>1 indicates an event is more likely on @entity109 . A test for interaction between treatment and @entity410 type (partial versus generalized onset) was also undertaken. MAIN RESULTS: Data are available for 684 @entity1 from four trials, representing 59% of the @entity1 recruited into the nine trials that met our inclusion criteria. The main overall results (HR 95% CI) adjusted for @entity410 type were, (i) time to withdrawal 1.63(1.23 to 2.15), (ii) time to 12 month remission 0.87(0.65 to 1.17), (iii) time to first @entity410 0.85(0.68 to 1.05). The review suggests that time to withdrawal is significantly improved with @entity2049 compared to @entity109 . No overall difference between drugs is identified for the outcomes 'time to 12 month remission' and 'time to first @entity410 '. Statistical heterogeneity was not encountered. An interaction between treatment and @entity410 type, confirmed statistically, was identified for time to first @entity410 , where @entity109 was favoured for partial onset @entity410 and @entity2049 for generalized onset @entity410 . REVIEWER'S CONCLUSIONS: We found no overall difference between @entity2049 and @entity109 for time to 12 month remission or time to first @entity410 , however, subgroup analyses for time to first @entity410 suggest an advantage with @entity109 for partial onset @entity410 and a clinical advantage with @entity2049 for generalized onset @entity410 . @entity109 is significantly more likely to be withdrawn, indicating that it is less well tolerated than @entity2049 .
