Comparative efficacy of anti-epileptic drugs for neonatal seizures: A network meta-analysis

Pediatrics and Neonatology

Hong-Tao Cui¹  Meng-Yuan Qiao²  Wei-Bin Li³  Jing-Kun Miao³  Ling-Zhi Zhao⁴  Zhen-E Xu⁵  Qi-Xiong Chen⁵ 

[1] Chongqing Key Laboratory of Pediatrics, Chongqing, China;Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China;National Clinical Research Center for Child Health and Disorders, Chongqing, China;Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China;Department of Neonatology, Children's Hospital of Chongqing Medical University, Chongqing, China;

关键词: Anti-epileptic drugs;    Levetiracetam;    Neonatal seizures;    Phenobarbital;   

DOI  :  

来源: DOAJ

【 摘 要 】

Background: Anti-epileptic drugs have different effects on neonatal seizures, and new agents have been widely used in recent years. Meanwhile, significant differences still exist in the treatment for neonatal seizures, whether in choice of drug or in duration of treatment. And with the increase in options for treatment, the best choice of second-line treatment has not been recommended. Methods: The MEDLINE, the Cochrane Library, Web of Science, Embase and clinicaltrials.gov databases were searched (January 1, 1960 to October 20, 2020). Randomized controlled trials (RCTs) or observational investigations studying anti-epileptic drugs for neonatal seizures were selected. And then we conducted a network meta-analysis and examined comparative efficacy of the first-line and second-line anti-epileptic drugs for neonatal seizures. Results: Data were extracted from 11 included studies by 2 independent investigators. Random effects models were used to estimate odds ratios (ORs). We performed direct meta-analyses with a random effects model and network meta-analyses for first-line and second-line drugs. Five published RCTs and 6 observational investigations with 1333 patients and 6 interventions contributed to the analysis. Conclusion: We recommend phenobarbital as the first-line drug for neonatal seizures. In addition, there is a tendency for levetiracetam to be an effective second-line treatment for neonatal seizures after failure of first-line drugs.

【 授权许可】

Unknown