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Etosuksymid, walproinian sodu lub lamotrygina w leczeniu padaczki z napadami nieświadomości u dzieci i młodzieży

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Appendices

Appendix 1. Cochrane Epilepsy Group Specialized Register search strategy

#1 valproic or valproate or Epilim

#2 MeSH DESCRIPTOR Valproic Acid Explode All

#3 ethosuximide or Zarontin

#4 MeSH DESCRIPTOR Ethosuximide Explode All

#5 lamotrigine or Lamictal

#6 #1 OR #2 OR #3 OR #4 OR #5

#7 MeSH DESCRIPTOR Epilepsy, Absence Explode All

#8 absence adj1 (epilep* or seizure*)

#9 "petit mal"

#10 #7 OR #8 OR #9

#11 #6 AND #10

#12 INREGISTER AND >15/12/2015:CRSCREATED

#13 #11 AND #12

Appendix 2. CENTRAL via CRSO search strategy

#1 MESH DESCRIPTOR Valproic Acid EXPLODE ALL TREES

#2 convulex OR depacon OR depakene OR depakine OR depakote OR dpa OR epilim OR epival OR stavzor OR valproat* OR valproic OR vpa

#3 #1 OR #2

#4 MESH DESCRIPTOR Ethosuximide EXPLODE ALL TREES

#5 ethosuximide OR zarontin

#6 #4 OR #5

#7 epilepax OR lamictal OR lamotrigin*

#8 #3 OR #6 OR #7

#9 MESH DESCRIPTOR Epilepsy, Absence EXPLODE ALL TREES

#10 (absence NEXT seizure*):TI,AB,KY

#11 (absence NEXT epilep*):TI,AB,KY

#12 (petit mal):TI,AB,KY

#13 #9 OR #10 OR #11 OR #12

#14 #8 AND #13

#15 15/12/2015 TO 01/09/2016:CD

#16 #14 AND #15

Appendix 3. MEDLINE search strategy

This search strategy is based on the Cochrane Highly Sensitive Search Strategy for identifying randomized trials (Lefebvre 2011).

1. (randomized controlled trial or controlled clinical trial or pragmatic clinical trial).pt. or (randomi?ed or placebo or randomly).ab.

2. clinical trials as topic.sh.

3. trial.ti.

4. 1 or 2 or 3

5. exp animals/ not humans.sh.

6. 4 not 5

7. (valproic or valproate or Epilim).tw.

8. *Valproic Acid/

9. (ethosuximide or Zarontin).tw.

10. *Ethosuximide/

11. (lamotrigine or Lamictal).tw.

12. 7 or 8 or 9 or 10 or 11

13. exp Epilepsy, Absence/

14. (absence adj1 (epilep$ or seizure$)).tw.

15. petit mal.tw.

16. 13 or 14 or 15

17. 6 and 12 and 16

18. remove duplicates from 17

19. limit 18 to ed=20151215‐20160901

Appendix 4. ClinicalTrials.gov search strategy

Condition: absence seizures OR absence epilepsy

Intervention: Ethosuximide OR sodium valproate OR lamotrigine

First received from 12/17/2015 to 09/01/2016

Appendix 5. WHO International Clinical Trials Registry Platform (ICTRP) search strategy

Condition: absence seizures OR absence epilepsy

Intervention: Ethosuximide OR sodium valproate OR lamotrigine

Date of registration between 17/12/2015 and 01/09/2016

Appendix 6. SCOPUS search strategy

(((TITLE‐ABS‐KEY(valproic or valproate or Epilim)) OR (TITLE‐ABS‐KEY(ethosuximide or Zarontin)) OR (TITLE‐ABS‐KEY(lamotrigine or Lamictal))) AND ((TITLE‐ABS‐KEY(absence W/1 (epilep* or seizure*))) OR (TITLE‐ABS‐KEY("petit mal"))) AND (TITLE((randomiz* OR randomis* OR controlled OR placebo OR blind* OR unblind* OR "parallel group" OR crossover OR "cross over" OR cluster OR "head to head") PRE/2 (trial OR method OR procedure OR study)) OR ABS((randomiz* OR randomis* OR controlled OR placebo OR blind* OR unblind* OR "parallel group" OR crossover OR "cross over" OR cluster OR "head to head") PRE/2 (trial OR method OR procedure OR study)))) AND (PUBYEAR > 2003)

Study flow diagram (results refer only to the updated version of the review).
Figuras y tablas -
Figure 1

Study flow diagram (results refer only to the updated version of the review).

'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
Figuras y tablas -
Figure 2

'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
Figuras y tablas -
Figure 3

'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.

Comparison 1 Ethosuximide versus valproate, Outcome 1 Seizure free.
Figuras y tablas -
Analysis 1.1

Comparison 1 Ethosuximide versus valproate, Outcome 1 Seizure free.

Comparison 1 Ethosuximide versus valproate, Outcome 2 80% or greater reduction in seizure frequency.
Figuras y tablas -
Analysis 1.2

Comparison 1 Ethosuximide versus valproate, Outcome 2 80% or greater reduction in seizure frequency.

Comparison 1 Ethosuximide versus valproate, Outcome 3 50% or greater reduction in seizure frequency.
Figuras y tablas -
Analysis 1.3

Comparison 1 Ethosuximide versus valproate, Outcome 3 50% or greater reduction in seizure frequency.

Comparison 2 Lamotrigine versus valproate, Outcome 1 Seizure free.
Figuras y tablas -
Analysis 2.1

Comparison 2 Lamotrigine versus valproate, Outcome 1 Seizure free.

Comparison 2 Lamotrigine versus valproate, Outcome 2 Normalization fo the EEG.
Figuras y tablas -
Analysis 2.2

Comparison 2 Lamotrigine versus valproate, Outcome 2 Normalization fo the EEG.

Comparison 3 Ethosuximide versus lamotrigine, Outcome 1 Seizure free at 12 months.
Figuras y tablas -
Analysis 3.1

Comparison 3 Ethosuximide versus lamotrigine, Outcome 1 Seizure free at 12 months.

Table 1. Adverse effects on valproate: number of participants experiencing each event

Event

Callaghan 1982

Sato 1982

Martinovic 1983

Coppola 2004

Huang 2009

Glauser 2013

Acute pancreatitis

1

Obesity/Weight gain

1

1

14

Drowsiness

4

Nausea

5

3

12*

Vomiting

1

2

12*

Decreased platelet numbers

2

4

Increased appetite

15

Poor appetite

1

8

Diarrhoea

1

7

Dizziness

1

2

Hyperactivity

23

Attention problems

24

Hostility

22

Concentration decreased

18

Personality change

17

Sleep problem

17

Depression

11

Slow process speed

11

Memory problem

10

Apathy

9

Fatigue

27

Headache

1

18

Leukopenia

2

Elevated liver function tests

1

7

Elevated LDH

1

Rash

2

* Nausea, vomiting, or both
LDH: lactate dehydrogenase

Numbers of individuals within each study undertaking valproate: 14 (Callaghan 1982), 22 (Sato 1982), 10 (Martinovic 1983), 19 (Coppola 2004), 23 (Huang 2009), 146 (Glauser 2013a).

Figuras y tablas -
Table 1. Adverse effects on valproate: number of participants experiencing each event
Table 2. Adverse effects on ethosuximide: number of participants experiencing each event

Event

Callaghan 1982

Sato 1982

Martinovic 1983

Glauser 2013

Drowsiness

1

5

Tiredness

2

Nausea

3

2

29*

Vomiting

3

29*

Increased appetite

6

Poor appetite

1

10

Diarrhoea

9

Dizziness

1

10

Headache

2

23

Leukopenia

3

Hiccups

1

Moodiness

1

Hyperactivity

13

Attention problems

8

Hostility

4

Concentration decreased

6

Personality change

6

Sleep problem

11

Depression

4

Slow process speed

3

Memory problem

0

Apathy

4

Fatigue

26

Rash

6

* Nausea, vomiting, or both

Numbers of individuals within each study undertaking ethosuximide: 14 (Callaghan 1982), 23 (Sato 1982), 10 (Martinovic 1983), 154 (Glauser 2013a).

Figuras y tablas -
Table 2. Adverse effects on ethosuximide: number of participants experiencing each event
Table 3. Adverse effects on lamotrigine: number of participants experiencing each event

Event

Frank 1999

Coppola 2004

Huang 2009

Glauser 2013

Abdominal pain

5

Headache

2

2

14

Nausea

3

2*

Vomiting

2*

Poor appetite

2

9

Increased appetite

1

10

Diarrhoea

2

Dizziness

3

5

5

Hyperkinesia

2

Hyperactivity

12

Attention problems

11

Hostility

11

Concentration decreased

9

Personality change

10

Sleep problem

5

Depression

11

Slow process speed

7

Memory problem

8

Apathy

3

Fatigue

1

18

Rash

10

1

2

6

Nervousness

1

Diplopia

1

* Nausea, vomiting, or both

Numbers of individuals within each study undertaking lamotrigine: 15 (Frank 1999), 19 (Coppola 2004), 24 (Huang 2009), 146 (Glauser 2013a).

Figuras y tablas -
Table 3. Adverse effects on lamotrigine: number of participants experiencing each event
Comparison 1. Ethosuximide versus valproate

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Seizure free Show forest plot

4

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

1.1 Drug naive

4

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2 80% or greater reduction in seizure frequency Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

2.1 Previously treated

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3 50% or greater reduction in seizure frequency Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 1. Ethosuximide versus valproate
Comparison 2. Lamotrigine versus valproate

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Seizure free Show forest plot

4

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

1.1 Seizure free at 1 month

2

Risk Ratio (M‐H, Fixed, 95% CI)

8.42 [2.77, 25.59]

1.2 Seizure free at 3 months

3

Risk Ratio (M‐H, Fixed, 95% CI)

1.64 [1.16, 2.31]

1.3 Seizure freedom at 6 months

1

Risk Ratio (M‐H, Fixed, 95% CI)

1.42 [0.88, 2.28]

1.4 Seizure free at 12 months

4

Risk Ratio (M‐H, Fixed, 95% CI)

1.67 [1.32, 2.11]

2 Normalization fo the EEG Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 2. Lamotrigine versus valproate
Comparison 3. Ethosuximide versus lamotrigine

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Seizure free at 12 months Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 3. Ethosuximide versus lamotrigine