| 摘要: |
| 目的：系统比较左乙拉西坦（LEV）和其他新型抗癫痫药物[奥卡西平（OXC）、拉莫三嗪（LTG）、托吡酯（TPM）]治疗儿童癫痫的安全性。方法：检索Web of Science、PubMed、EMBase、the Cochrane Library、中国知网、万方、维普、中国生物医学文献数据库，筛选LEV对比其他新型抗癫痫药物的随机对照试验（RCT）进行Meta分析，检索时间自各数据库建库起至2021年9月8日。筛选文献并提取相关数据，采用Cochrane系统评价员手册（5.1.0）推荐的偏倚风险评估工具对纳入文献质量进行评价，采用RevMan 5.3软件进行Meta分析、发表偏倚分析。结果：共纳入16项RCT，共计1 281例患者。Meta分析结果显示，试验组不良反应发生率低于对照组（RR=0.64，95%CI 0.50~0.81，P=0.0002）；亚组分析结果显示，LEV组不良反应发生率低于OXC组（RR=0.47，95%CI 0.29~0.76，P=0.002）和LTG组（RR=0.35，95%CI 0.16~0.73，P=0.006），而与TPM组比较差异无统计学意义（RR=0.78，95%CI 0.55~1.09，P=0.15）。本研究存在一定的发表偏倚。结论：新型抗癫痫药物尤其是LEV治疗儿童癫痫的安全性良好。 |
| 关键词: 左乙拉西坦 奥卡西平 拉莫三嗪 托吡酯 安全性 Meta分析 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2022.09.006 |
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| 基金项目:山东省医学会临床科研专项资金项目,编号YXH2020ZX045 |
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| Meta-Analysis on Safety of Levetiracetam in the Treatment of Epilepsy in Children |
| Li Rui1, Shen Hongxia2, Xu Lujie2, Gao Shiman2, Yan Meixing2 |
| (1. Ocean University of China, Shandong Qingdao 266000, China; 2. Qingdao Women and Children’s Hospital, Shandong Qingdao 266000, China) |
| Abstract: |
| Objective: To systematically compare the safety of levetiracetam (LEV) and other novel antiepileptic drugs such as oxcarbazepine (OXC), lamotrigine (LTG) and topiramate (TPM) in the treatment of epilepsy in children. Methods: Web of Science, PubMed, EMBase, the Cochrane Library, CNKI, Wanfang, VIP and CBM database were retrieved to collect the randomized controlled trials (RCT) of comparison of LEV and other novel antiepileptic drugs in the treatment of epilepsy in children. The retrieval time was from the establishment of the database to Sept. 8th, 2021. Literature was screened and relevant data were extracted. The quality of the included literature was evaluated by the risk of bias assessment tool recommended by the Cochrane Manual for Systematic Reviewers 5.1.0. RevMan 5.3 software was used for Meta-analysis and publication bias analysis. Results: A total of 16 RCT were enrolled, including 1,281 patients. Meta-analysis showed that the incidence of adverse drug reactions in the experimental group was lower than that in the control group (RR=0.64, 95%CI from 0.50 to 0.81, P=0.000,2). Subgroup analysis showed that the incidence of adverse drug reactions in the LEV group was lower than that in the OXC group (RR=0.47, 95%CI from 0.29 to 0.76, P=0.002) and the LTG group (RR=0.35, 95%CI from 0.16 to 0.73, P=0.006 ), but there was no significant difference compared with the TPM group (RR=0.78, 95%CI from 0.55 to 1.09, P=0.15). There was some publication bias in this study. Conclusion: The safety of novel antiepileptic drugs, especially LEV, in the treatment of childhood epilepsy is higher. |
| Key words: levetiracetam oxcarbazepine lamotrigine topiramate safety Meta-analysis |
