Network meta analysis of lacosamide,perampanel and brivaracetam as add-on treat-ments in partial seizures of refractory epilepsy and pharmacoeconomic evaluation
Network meta analysis of lacosamide,perampanel and brivaracetam as add-on treat-ments in partial seizures of refractory epilepsy and pharmacoeconomic evaluation
Objective To systematically evaluate the efficacy,tolerability,and cost-effectiveness of Lacosamide,Perampanel and Brivaracetam as add-on treatments in partial seizures of refractory epilepsy.Methods Randomized controlled trials(RCTs)published from the inception of each database to June 2024 were collected from CNKI,Wanfang,VIP,PubMed,Embase and Cochrane Library databases.Literature data were screened,extracted and assessed for quality based on inclusion and exclusion criteria.Drug efficacy and tolerability were analyzed using Network Meta Analysis with Stata 15.0 software.Based on the analysis results,cost-minimization analysis was applied to evaluate the economics of three anti-seizure medicines(ASMs).Results A total of 12 literatures involving 5369 patients were included.The results of Network Meta Analysis revealed that there were no statistically significant differences in the efficacy and tolerability of the three above ASMs when they were pairwisely compared(P＞0.05).However,clustering analysis of comprehensive efficacy and tolerability showed that brivaracetam ranked the best.Pharmacoeconomic analysis showed that Perampanel was currently the most economical choice when compared to imported original drugs or domestically produced generic drugs.Conclusion Lacosamide,Perampanel and Brivaracetam as add-on treatments in partial seizures of refractory epilepsy demonstrated no significant differences in efficacy and tol-erability when they were compared to each another.If the latest marketed brivaracetam is included in central-ized procurement and national medical insurance in the future,it may be a better choice as an add-on treat-ment.
维普
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