Carbamazepine versus phenytoin monotherapy for epilepsy

Region‐specific changes in gene expression in rat brain after chronic treatment with levetiracetam or phenytoin

“…Although we do not know whether these nuclei responded to levetiracetam therapy with alterations in gene expression, and although the pons/medulla sample is heterogeneous with respect to neuronal populations, the present findings raise the question whether levetiracetam owes some of its antiepileptic or adverse effects to a primary action in the brainstem. The effect of phenytoin on gene expression in frontal cortex and hippocampus agrees with its therapeutic effect on epilepsies that originate from foci in these structures and on epilepsies with generalized onset (Tudur Smith et al, 2002). An effect of phenytoin on the firing pattern of cortical neurons could, for example, result in broad adjustments to synaptic activity that is reflected in the pattern of gene expression.…”

Region‐specific changes in gene expression in rat brain after chronic treatment with levetiracetam or phenytoin

“…Although we do not know whether these nuclei responded to levetiracetam therapy with alterations in gene expression, and although the pons/medulla sample is heterogeneous with respect to neuronal populations, the present findings raise the question whether levetiracetam owes some of its antiepileptic or adverse effects to a primary action in the brainstem. The effect of phenytoin on gene expression in frontal cortex and hippocampus agrees with its therapeutic effect on epilepsies that originate from foci in these structures and on epilepsies with generalized onset (Tudur Smith et al, 2002). An effect of phenytoin on the firing pattern of cortical neurons could, for example, result in broad adjustments to synaptic activity that is reflected in the pattern of gene expression.…”

ILAE Treatment Guidelines: Evidence‐based Analysis of Antiepileptic Drug Efficacy and Effectiveness as Initial Monotherapy for Epileptic Seizures and Syndromes

“…The meta‐analyses found “no reliable evidence to distinguish CBZ and VPA for partial onset seizures and generalized‐onset seizures” (67) and that CBZ is better tolerated than PB, but no efficacy difference between the two could be demonstrated (71). No differences were found for PHT versus VPA, or CBZ versus PHT (68,69). For the PHT versus PB comparison, PHT was superior to PB for time to withdrawal of treatment, but no difference was noted between the two AEDs for time to 12‐month remission and a nonsignificant trend toward a preference for PB over PHT for time to first seizure (70).…”

“…A total of 37 RCTs (9,31–66) and five meta‐analyses (66–71) examined initial monotherapy of adults with partial‐onset seizures. Among the 37 RCTs, two RCTs (9,31) were considered class I studies, one RCT was rated as class II (34), and 30 RCTs met criteria for class III studies (32,33,35–61,66).…”

“…A total of 26 RCTs (32,33,35–39,41,43,44,48–51,53–60,63–65,91) and five meta‐analyses (67–71) examined initial monotherapy of adults with GTC seizures. Three RCTs did not report effectiveness or efficacy as a primary outcome variable and are not included further in the analysis (63–65).…”

Exploring changes over time and characteristics associated with data retrieval across individual participant data meta-analyses: systematic review

“…For the reviews and network meta-analyses published up to 2007, 34 45 46 47 48 49 50 51 we requested IPD for a total of 5887 participants from 29 randomised trials and we successfully received IPD for 4703 (80%) participants from 18 (62%) of these eligible trials. In addition, we had IPD available from our own SANAD trial, 52 53 the largest trial in epilepsy at the time, in which 2437 participants were randomised.…”

Region‐specific changes in gene expression in rat brain after chronic treatment with levetiracetam or phenytoin

“…Although we do not know whether these nuclei responded to levetiracetam therapy with alterations in gene expression, and although the pons/medulla sample is heterogeneous with respect to neuronal populations, the present findings raise the question whether levetiracetam owes some of its antiepileptic or adverse effects to a primary action in the brainstem. The effect of phenytoin on gene expression in frontal cortex and hippocampus agrees with its therapeutic effect on epilepsies that originate from foci in these structures and on epilepsies with generalized onset (Tudur Smith et al, 2002). An effect of phenytoin on the firing pattern of cortical neurons could, for example, result in broad adjustments to synaptic activity that is reflected in the pattern of gene expression.…”

ILAE Treatment Guidelines: Evidence‐based Analysis of Antiepileptic Drug Efficacy and Effectiveness as Initial Monotherapy for Epileptic Seizures and Syndromes

“…The meta‐analyses found “no reliable evidence to distinguish CBZ and VPA for partial onset seizures and generalized‐onset seizures” (67) and that CBZ is better tolerated than PB, but no efficacy difference between the two could be demonstrated (71). No differences were found for PHT versus VPA, or CBZ versus PHT (68,69). For the PHT versus PB comparison, PHT was superior to PB for time to withdrawal of treatment, but no difference was noted between the two AEDs for time to 12‐month remission and a nonsignificant trend toward a preference for PB over PHT for time to first seizure (70).…”

“…A total of 37 RCTs (9,31–66) and five meta‐analyses (66–71) examined initial monotherapy of adults with partial‐onset seizures. Among the 37 RCTs, two RCTs (9,31) were considered class I studies, one RCT was rated as class II (34), and 30 RCTs met criteria for class III studies (32,33,35–61,66).…”

“…A total of 26 RCTs (32,33,35–39,41,43,44,48–51,53–60,63–65,91) and five meta‐analyses (67–71) examined initial monotherapy of adults with GTC seizures. Three RCTs did not report effectiveness or efficacy as a primary outcome variable and are not included further in the analysis (63–65).…”

Exploring changes over time and characteristics associated with data retrieval across individual participant data meta-analyses: systematic review

“…For the reviews and network meta-analyses published up to 2007, 34 45 46 47 48 49 50 51 we requested IPD for a total of 5887 participants from 29 randomised trials and we successfully received IPD for 4703 (80%) participants from 18 (62%) of these eligible trials. In addition, we had IPD available from our own SANAD trial, 52 53 the largest trial in epilepsy at the time, in which 2437 participants were randomised.…”

Region‐specific changes in gene expression in rat brain after chronic treatment with levetiracetam or phenytoin

“…Although we do not know whether these nuclei responded to levetiracetam therapy with alterations in gene expression, and although the pons/medulla sample is heterogeneous with respect to neuronal populations, the present findings raise the question whether levetiracetam owes some of its antiepileptic or adverse effects to a primary action in the brainstem. The effect of phenytoin on gene expression in frontal cortex and hippocampus agrees with its therapeutic effect on epilepsies that originate from foci in these structures and on epilepsies with generalized onset (Tudur Smith et al, 2002). An effect of phenytoin on the firing pattern of cortical neurons could, for example, result in broad adjustments to synaptic activity that is reflected in the pattern of gene expression.…”

ILAE Treatment Guidelines: Evidence‐based Analysis of Antiepileptic Drug Efficacy and Effectiveness as Initial Monotherapy for Epileptic Seizures and Syndromes

“…The meta‐analyses found “no reliable evidence to distinguish CBZ and VPA for partial onset seizures and generalized‐onset seizures” (67) and that CBZ is better tolerated than PB, but no efficacy difference between the two could be demonstrated (71). No differences were found for PHT versus VPA, or CBZ versus PHT (68,69). For the PHT versus PB comparison, PHT was superior to PB for time to withdrawal of treatment, but no difference was noted between the two AEDs for time to 12‐month remission and a nonsignificant trend toward a preference for PB over PHT for time to first seizure (70).…”

“…A total of 37 RCTs (9,31–66) and five meta‐analyses (66–71) examined initial monotherapy of adults with partial‐onset seizures. Among the 37 RCTs, two RCTs (9,31) were considered class I studies, one RCT was rated as class II (34), and 30 RCTs met criteria for class III studies (32,33,35–61,66).…”

“…A total of 26 RCTs (32,33,35–39,41,43,44,48–51,53–60,63–65,91) and five meta‐analyses (67–71) examined initial monotherapy of adults with GTC seizures. Three RCTs did not report effectiveness or efficacy as a primary outcome variable and are not included further in the analysis (63–65).…”

Exploring changes over time and characteristics associated with data retrieval across individual participant data meta-analyses: systematic review

“…For the reviews and network meta-analyses published up to 2007, 34 45 46 47 48 49 50 51 we requested IPD for a total of 5887 participants from 29 randomised trials and we successfully received IPD for 4703 (80%) participants from 18 (62%) of these eligible trials. In addition, we had IPD available from our own SANAD trial, 52 53 the largest trial in epilepsy at the time, in which 2437 participants were randomised.…”