Efficacy of vigabatrin in the treatment of infantile epileptic spasms syndrome: A systematic review and meta‐analysis

Bibliographic Details
Title: Efficacy of vigabatrin in the treatment of infantile epileptic spasms syndrome: A systematic review and meta‐analysis
Authors: Zhao Xu, Pan Gong, Xianru Jiao, Yue Niu, Ye Wu, Yuehua Zhang, Xingzhi Chang, Zhixian Yang
Source: Epilepsia Open, Vol 8, Iss 2, Pp 268-277 (2023)
Publisher Information: Wiley, 2023.
Publication Year: 2023
Collection: LCC:Neurology. Diseases of the nervous system
Subject Terms: hormonal therapy, infantile epileptic spasms syndrome, tuberous sclerosis complex, vigabatrin, Neurology. Diseases of the nervous system, RC346-429
More Details: Abstract This systematic review and meta‐analysis aimed to evaluate the efficacy of vigabatrin (VGB) in treating infantile epileptic spasms syndrome (IESS). Databases of PubMed, Embase, Web of Science, MEDLINE, and Cochrane Library were systematically searched. All the relevant randomized controlled trials (RCTs) and observational studies (OSs) of VGB for IESS were included and analyzed separately. The primary outcome was the cessation of epileptic spasms (ES). Five RCTs and nine OSs compared the efficacy of VGB vs hormonal monotherapy for IESS. Meta‐analysis of the five RCTs showed that hormonal monotherapy was significantly better than VGB monotherapy (OR = 0.37, 95% CI = 0.20‐0.67) for patients with new‐onset IESS. Meta‐analysis of the nine OSs agrees with the result from RCTs (OR = 0.61, 95% CI = 0.43‐0.85). VGB was more effective in patients with TSC than in those with other etiologies (five OSs, OR = 5.59, 95% CI = 2.17‐14.41). There was no significant difference in the efficiency of VGB combined with hormonal therapy vs hormonal monotherapy for IESS (two RCTs, OR = 0.75, 95% CI = 0.09‐6.45). Hormonal monotherapy is better than VGB monotherapy for non‐TSC‐associated IESS. But for patients with IESS due to TSC, VGB is the first choice. VGB combined with hormone therapy does not definitely increase ES control rates compared with that of hormonal monotherapy.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2470-9239
Relation: https://doaj.org/toc/2470-9239
DOI: 10.1002/epi4.12703
Access URL: https://doaj.org/article/f05b19e2f8c4456b86ed321eb532d6e2
Accession Number: edsdoj.f05b19e2f8c4456b86ed321eb532d6e2
Database: Directory of Open Access Journals
More Details
ISSN:24709239
DOI:10.1002/epi4.12703
Published in:Epilepsia Open
Language:English