Systematic Review of Levetiracetam as Adjunctive Therapy for Refractory Focal Epilepsy
Objective To evaluate the efficacy and safety of levetiracetam(LEV)in the adjuvant treatment of refractory focal epilepsy.Methods Randomized controlled trials(RCT)on the adjuvant treatment of refractory focal epilepsy with levetiracetam were searched from Chinese and English databases.The search time was from database establishment to March 2023.Two researchers evaluated the quality of the included literature strictly.Meta-analysis of each effect index was performed by RevMan 5.3 software.Results Sever clinical randomized,double-blind,placebo trials were included.There were 1223 cases,including 647 in the levetiracetam group and 576 in the placebo group.Meta-analysis showed that the mean number of refractory focal seizures per week in the levetiacetam group was reduced by≥50%response rate(OR=3.44,95%CI:2.62-4.52,P<0.05)and≥75%response rate(OR=4.89,95%CI:2.69-8.88,P<0.05),There were statistically different between the two groups.There were statistical differences in the drug-related serious adverse reactions(RR=1.93,95%CI:1.06-3.53,P<0.05),drowsiness(RR=1.46,95%CI:1.08-1.99,P<0.05),musculoskeletal and conjunctival complications(RR=1.93,95%CI:1.15-3.25,P<0.05),but there were no statistical differences in the incidence of dizziness,headache,gastrointestinal discomfort(such as nausea,abdominal pain,diarrhea),infection(invasion),blood biochemical abnormalities,electrocardiogram abnormalities,diplopia,tinnitus,pruritus,nasopharyngitis,and memory deficit(P>0.05).Conclusion The adjuvant treatment of levetiracetam in refractory focal epilepsy has a consolidation effect and a significant effect of reducing the number of seizures.
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