A Meta-analysis Of Oxcarbazepine As Add-on Therapy Of Adults With Refractory Partial-onset Seizures

Objective: To evaluate the efficacy and safety of oxcarbazepine as add-on therapy of adults with refractory partial-onset epilepsy.Methods:Computer searched Cochrane Library,Pub Med,Embase,CBM,CNKI,VIP,WANFANG Database for all randomized controlled trials of add-on oxcarbazepine therapy in refractory partial-onset seizures published before December 30,2019.Two researchers independently screened literatures,extracted data and assessed the methodological quality.Meta-analysis was conducted by Rev Man5.3 software.We choose the heterogeneity was evaluated by Q test and I2 value,and the relative risk and 95% confidence interval on behalf of the estimated effect size.Results: Two studies involving 1058 patients were included.The results of meta-analysis were compared between the oxcarbazepine all-dose group,the 1200mg/d group and the 2400mg/d group and the placebo group.About efficacy indicators,all groups had no statistical difference with placebo in term of seizure-free rate,and percentage of patients achieving 50% reduction in seizure frequency(P>0.05).About safety indicators,compared with placebo group,Incidence of withdrawal because of adverse reactions was higher in the oxcarbazepine all-dose group[RR=3.80,95%CI(2.57,5.62),P<0.00001],1200mg/d group[RR=2.84,95%CI(1.24,6.51),P=0.01],2400mg/d group[RR=5.46,95%CI(2.62,11.37),P<0.00001].The Incidence of adverse reactions was higher in the oxcarbazepine all-dose group[RR=1.17,95%CI(1.08,1.27),P=0.0002],1200mg/d group[RR=1.13,95%CI(1.03,1.24),P=0.01],2400mg/d group[RR=1.27,95%CI(1.16,1.39),P<0.00001] compared with placebo group.All groups had no statistical difference with placebo in term of serious adverse reactions(P>0.05).Conclusions:According to the existing evidence,oxcarbazepine as add-on therapy of adults with refractory partial-onset epilepsy did not show obvious efficacy,and the tolerance of patients was low.The incidence of adverse reactions was higher than that of the placebo group,but the incidence of serious adverse reactions was similar to that of the placebo group.