title: Clinical efficacy and safety of the newer antiepileptic drugs as adjunctive treatment in adults with refractory partial-onset epilepsy: a meta-analysis of randomized placebo-controlled trials.
abstract: OBJECTIVE
  To evaluate the clinical efficacy and safety of the newer antiepileptic drugs (AEDs), namely, Eslicarbazepine (ESL), Retigabine/Ezogabine (RTG), Carisbamate (CAR), Lacosamide (LAC), Brivaracetam (BRI) or Perampanel (PER) as adjunctive therapy for adults with partial-onset seizures (POS).
  
  
  METHODS
  A systematic review of Randomized placebo-controlled Trials (RCTs) of newer AEDs was conducted. Electronic databases and identified bibliographies were searched to retrieve RCTs. The primary outcomes were responder rates and withdrawal rates, adverse effects. Pooled effects of odds ratio (OR), risk ratio (RR) and risk differences (RD) were derived from meta-analysis implemented in Revmen 5.1.
  
  
  RESULTS
  In total, 15 RCTs were included. All the studies contained a baseline and treatment phase. The pooled OR of all newer AEDs vs placebo was 2.16 (95% CI: 1.82, 2.57) for responder rates, 1.54 (1.12, 2.10) for withdrawal rates, 1.67 (1.34, 2.08) for adverse effects. The indirect comparisons between individual newer AED and all other newer AEDs suggested the similar results in responder rates (ORs, BRI 1.79 [-1.50, 5.08], RTG 1.41 [0.49, 2.33]).
  
  
  CONCLUSIONS
  The pooled ORs suggested newer AEDs might be more effective than placebo while with higher incidence of adverse effects. The indirect comparisons suggested BRI, followed by RTG, might be more effective than all other newer AEDs, which could be confirmed by future clinical studies.
authors: School of Biomedical Sciences and Pharmacy, University of Newcastle, Australia.
authors: Lan
authors: L
authors: Gao
authors: Li
authors: L
authors: Xia
authors: Fei-Li
authors: FL
authors: Zhao
authors: Shu-Chuen
authors: SC
authors: Li
mesh_terms: D000927:Anticonvulsants / Q000008:administration & dosage* / Q000009:adverse effects; D004359:Drug Therapy, Combination; D015507:Drugs, Investigational / Q000008:administration & dosage* / Q000009:adverse effects; D004828:Epilepsies, Partial / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants; D015507:Drugs, Investigational