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首页> 外文期刊>Chinese Journal of Contemporary Neurology and Neurosurgery >Evaluation of the efficacy and safety of topiramate as adjunctive drug in the treatment of refractory partial seizures with Meta-analysis
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Evaluation of the efficacy and safety of topiramate as adjunctive drug in the treatment of refractory partial seizures with Meta-analysis

机译：荟萃分析评价托吡酯作为辅助药物治疗难治性部分性癫痫的疗效和安全性

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Background Epilepsy is a chronic neurological condition characterized by paroxysm of seizures due to abnormal electrical discharge from central nervous system neurons. Several new antiepileptic drugs (AEDs) were listed over the past two decades, and they were believed to be equally effective and have better tolerability and side effect profiles. This paper aims to evaluate the efficacy and safety of adjunctive topiramate in refractory partial seizures. Methods Relevant research articles about?randomized controlled trials of adjunctive topiramate in refractory partial seizures, with topiramate, Topamax, add-on treatment, adjunctive treatment, add-on therapy, adjunctive therapy, refractory partial seizure, refractory partial epilepsy both in Chinese and English as retrieval words, were retrieved from PubMed (1995-2014), Cochrane Central Register of Controlled Trials (CENTRAL, 1995-2014), The Cochrane Database of Systematic Reviews (CDSR, 1995-2014), China National Knowledge Infrastructure (CNKI, 1995-2014) and Wanfang Data (1999-2014). Two reviewers independently evaluated the quality of the included articles and abstracted the data. A Meta-analysis was conducted using RevMan 5.0 software. Results According to the enrollment criteria, 13 prospective, randomized controlled clinical trials with a total of 1622 patients were finally selected. The proportions of patients with reduction in seizure frequency ≥ 50% (OR = 3.710, 95% CI: 2.870-4.810; P = 0.000), ≥ 75% (OR = 7.220, 95% CI: 3.310-15.750; P = 0.000) and seizure free (OR = 3.380, 95%CI: 1.720-6.640; P = 0.000) in topiramate group were significantly higher than that in control group. The treatment withdrawal ratio was significantly higher compared to placebo in 600 mg/d and 800 mg/d subgroups, but not in 200 mg/d subgroup (200 mg/d: OR = 2.170, 95%CI: 0.470-9.950, P = 0.320; 600 mg/d: OR = 2.090, 95%CI: 1.020-4.270, P = 0.040; 800 mg/d: OR = 8.000, 95%CI: 1.390-46.140, P = 0.020). The common side effects included somnolence, anorexia, ataxia, aprosexia, dizziness, fatigue, nausea, thinking abnormality, paraesthesia and weight loss. The occurrence rate of side effects in topiramate group was higher than that in control group. Conclusions Topiramate is effective when added to existing therapy in patients with refractory partial seizures. The withdrawal rate of 200 mg/d topiramate is similar to control group. Compared with the control group, adverse effects are more common but mild or moderate, mainly related with the central nervous system. However, trials included in this study are of relatively short duration, and provide no evidence for the long-term efficacy of topiramate.?doi:?10.3969/j.issn.1672-6731.2014.11.007.
机译：背景技术癫痫病是一种慢性神经系统疾病，其特征在于由于中枢神经系统神经元的异常放电导致癫痫发作。在过去的二十年中，已经列出了几种新的抗癫痫药（AED），它们被认为是同等有效的，并且具有更好的耐受性和副作用。本文旨在评估辅助托吡酯在难治性部分性癫痫发作中的疗效和安全性。方法中，英，托吡酯，Topamax，附加治疗，辅助治疗，附加疗法，辅助治疗，难治性部分性癫痫，难治性部分性癫痫随机对照试验的相关研究文章作为检索词，检索自PubMed（1995-2014），Cochrane对照试验中心登记册（CENTRAL，1995-2014），Cochrane系统评价数据库（CDSR，1995-2014），中国国家知识基础设施（CNKI，1995） -2014）和万方数据（1999-2014）。两位审稿人独立评估了所包含文章的质量并提取了数据。使用RevMan 5.0软件进行荟萃分析。结果根据入组标准，最终选择了13项前瞻性，随机对照临床试验，总共1622例患者。癫痫发作频率降低的患者比例≥50％（OR = 3.710，95％CI：2.870-4.810; P = 0.000），≥75％（OR = 7.220，95％CI：3.310-15.750; P = 0.000）托吡酯组和无癫痫发作（OR = 3.380，95％CI：1.720-6.640; P = 0.000）显着高于对照组。与安慰剂相比，在600 mg / d和800 mg / d的亚组中，治疗撤回率显着高于安慰剂，但在200 mg / d的亚组中，则不高于安慰剂（200 mg / d：OR = 2.170，95％CI：0.470-9.950，P = 0.320; 600mg / d：OR ＝ 2.090，95％CI：1.020-4.270，P ＝ 0.040; 800mg / d：OR ＝ 8.000，95％CI：1.390-46.140，P ＝ 0.020）。常见的副作用包括嗜睡，厌食，共济失调，乏力，头晕，疲劳，恶心，思维异常，感觉异常和体重减轻。托吡酯组的不良反应发生率高于对照组。结论托吡酯联合现有治疗对难治性部分性癫痫有效。 200 mg / d托吡酯的撤药率与对照组相似。与对照组相比，不良反应更为常见，但轻度或中度，主要与中枢神经系统有关。但是，本研究中包括的试验持续时间相对较短，并且未提供托吡酯长期疗效的证据。doi：？10.3969 / j.issn.1672-6731.2014.11.007。

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