Abstracts

Rationale: Various RCTs and uncontrolled studies to explore the efficacy of low Glycemic Index Therapy (LGIT) in children with drug resistant epilepsy (DRE) have been conducted since its introduction in 2005. This systematic review was performed to determine the efficacy of LGIT in form of proportion of children with >50% and >90% seizure frequency reduction from baseline at 3, 6 and 12 months after starting LGIT. Methods: Electronic databases like Pubmed/Medline, Web of Science, Embase, Scopus and Google scholar were searched in May 2019, using MeSH terms “low glycemic index therapy’’, ‘’epilepsy’’, ‘’seizure’’ and ‘’children’’. Results of one recently completed RCT (NCT03464487) were obtained directly from investigators. All articles were reviewed independently by two reviewers. Newcastle-Ottawa Scale (NOS) for nonrandomized studies and CONSORT criteria and Cochrane risk-of-bias tool for randomized trials were used for quality assessment. Metanalysis of the results of the eligible studies was performed after excluding case reports and review articles. The systematic review was registered with PROSPERO (ID 137589). Results: Fifty-one relevant articles were identified from 113 search items. Total 11 studies (3 RCTs, 2 prospective and 6 retrospective uncontrolled studies) describing 412 children were included in the systematic review. All 3 RCTs had low risk of bias and 7/8 nonrandomized studies were of high quality (NOS score ≥7). Since the other comparison arms in the three RCTs were different from each other, so only the results of one arm including LGIT were included in combining the results for metanalysis. About 52%, 52.5% and 56% children had >50% seizure reduction and about 25%, 30% and 33% had >90% seizure reduction at 3, 6 and 12 months after starting LGIT respectively. Conclusions: LGIT is efficacious in reducing seizure frequency in children with drug resistant epilepsy. Funding: No funding