A Meta Analysis About Levetiracetam Add-on Therapy For The QOL Of Epilepsy Patients

Objective: To systematically evaluate the effects of Levetiaracetama as an add-on therapy to the epilepsy patients in QOL(Quality of Life).Methods: Using electronic database, such as Medline Pubmed Online database, ScienceDirect database, ProQuest database, Ovid database, Cochrane Library, CNKI, et al, and searching for references, emailing authors or companies to achieve data, and according to the in/out standards which were made by the objective and searched data to choose data. At the end, calculating the SMD (Standard Mean Difference) and 95%CI (confidence interval) of LEV/placebo after therapy and LEV before/after therapy for each item and total score of QOLIE-31, that is Seizure Worry, Overall QOL, Emotional Well-Being, Energy-Fatigue, Cognitive Functioning, Medication Effects, Social Function and Health States, with RevMan 5.0.1 software in inverse Variance statistical method. If P>0.05, choose fixed effect analysis model, or else, choose random effects analysis model.Results: According to the in/out standards, there are 6 pieces of data,one is Chinese, two are English, the others are not published. All of these high-quality data are come from randomized, double blind, placebo-controlled trials, and the fail-safe number is so large that these data can stand for the entirety. Results of Meta-analysis shows that SMD and 95%CI of six items≥0 after therapy, that is, Seizure Worry(0.32[0.00,0.64]) (SMD[95%CI]), Overall QOL(0.29 [0.15, 0.44]),Cognitive Functioning(0.24 [0.10, 0.38]),Medication effect(s0.15 [0.00, 0.29]),Social Functioning(0.17 [0.03, 0.32]),Total Score(0.29 [0.14, 0.43]), the 95%CI of Emotional Well-Being, Energy-Fatigue contains 0, shows that LEV has the same effect as placebo. While before/after the therapy of LEV, the SMD and 95%CI of four items: Seizure Worry(0.25 [0.10, 0.40]), Overall QOL(0.25 [0.11, 0.40]), Cognitive Functioning(0.21 [0.06, 0.35]), Total Score(0.21 [0.06, 0.36])>0, and the 95%CI of the other four items contains 0, which means there are not much change after treatment.Conclusion: There are six items (Seizure Worry, Overall QOL, Cognitive Functioning, Medication effects, Social Functioning, Total Score)improved after treated by LEV/placebo, while only four items (Seizure Worry, Overall QOL, Cognitive Functioning, Total Score)get better before/after LEV therapy. Maybe it refers from the differences of included data. In a word, more multi-center, objective and more participants trials are needed in future.