Abstracts

Epilepsy is a common and chronic neurological disorder of childhood encountered by both general pediatricians and pediatric neurologists. Of the 3.5 million people who develop epilepsy annually, 40% are younger than 15 years and more than 80% live in developing countries. The choice of anti-epileptic drug (AED) is determined by diagnosis, but also the potential effectiveness and tolerability for an individual child. In the absence of head-to-head trials directly comparing AEDs in children with partial epilepsy, a scientific review is performed to compare the efficacy and tolerability of newer AEDs from available data. Levetiracetam is here compared to newer AEDs., Randomized placebo-controlled trials of add-on therapy with levetiracetam, lamotrigine, gabapentin, topiramate and oxcarbazepine in children with partial epilepsy were identified in the Cochrane Library Issue 2, 2006 and Medline (1996 to May 2006). The outcomes considered were the 50% responder rate (efficacy measure) and withdrawal rate (tolerability measure) of levetiracetam and these newer AEDs versus placebo. A fixed-effects analysis was used to estimate Mantel-Haenszel[apos]s odds ratio (OR) of these outcomes. Safety evaluation between these AEDs was assessed using Summary Complaint Scores (placebo events subtracted from AED events) on adverse events with an incidence of at least 10 %., One placebo-controlled trial was found for each AED. Levetiracetam (OR: 3.30 [95% CI: 1.75; 6.24]) and lamotrigine (OR: 3.82 [95% CI: 1.96; 7.45]) were more effective than gabapentin (OR: 1.36 [95% CI:0.71; 2.58]) and had similar withdrawal rates. Levetiracetam (OR: 0.44 [95% CI:0.17;1.15]) had a lower withdrawal rate than oxcarbazepine (OR: 2.15 [95% CI: 1.00; 4.60]) ; the efficacy of these drugs was comparable (OR: 2.39 [95% CI: 1.00; 4.60] for oxcarbazepine). Gabapentin (score of 15) and levetiracetam (38) showed a more favorable summary complaint score as compared with lamotrigine (69), topiramate (83) and oxcarbazepine (154)., This analysis suggest that add-on therapy with levetiracetam has a favorable responder and withdrawal rates, and Summary Complaint Scores relative to several AEDs in children with partial epilepsy at doses used in clinical trials. Comparative clinical trials and long-term studies of these agents are needed to confirm these findings and assist physicians in making the right treatment choice., (Supported by UCB S.A.)