title: Efficacy of antiepileptic drugs in adults predicts efficacy in children: a systematic review.
abstract: OBJECTIVE
  Due to the challenges inherent in performing clinical trials in children, a systematic review of published clinical trials was performed to determine whether the efficacy of antiepileptic drugs (AEDs) in adults can be used to predict the efficacy of AEDs in the pediatric population.
  
  
  METHODS
  Medline/PubMed, EMBASE, and Cochrane library searches (1970-January 2010) were conducted for clinical trials of partial-onset seizures (POS) and primary generalized tonic-clonic seizures (PGTCS) in adults and in children <2 and 2-18 years. Independent epidemiologists used standardized search and study evaluation criteria to select eligible trials. Forest plots were used to investigate the relative strength of placebo-subtracted effect measures.
  
  
  RESULTS
  Among 30 adjunctive therapy POS trials in adults and children (2-18 years) that met evaluation criteria, effect measures were consistent between adults and children for gabapentin, lamotrigine, levetiracetam, oxcarbazepine, and topiramate. Placebo-subtracted median percent seizure reduction between baseline and treatment periods (ranging from 7.0% to 58.6% in adults and from 10.5% to 31.2% in children) was significant for 40/46 and 6/6 of the treatment groups studied. The ≥50% responder rate (ranging from 2.0% to 43.0% in adults and from 3.0% to 26.0% in children) was significant for 37/43 and 5/8 treatment groups. In children <2 years, an insufficient number of trials were eligible for analysis.
  
  
  CONCLUSIONS
  This systematic review supports the extrapolation of efficacy results in adults to predict a similar adjunctive treatment response in 2- to 18-year-old children with POS.
authors.affiliation: Virginia Commonwealth University, Richmond, VA, USA. jpellock@mcvh-vcu.edu
authors.forename: John M
authors.initials: JM
authors.lastname: Pellock
authors.forename: Wendy J
authors.initials: WJ
authors.lastname: Carman
authors.forename: Veena
authors.initials: V
authors.lastname: Thyagarajan
authors.forename: Tony
authors.initials: T
authors.lastname: Daniels
authors.forename: Dexter L
authors.initials: DL
authors.lastname: Morris
authors.forename: O'Neill
authors.initials: O
authors.lastname: D'Cruz
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D004827:Epilepsy / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D055815:Young Adult
chemical_list: D000927:Anticonvulsants