The Efficacy of Leviteracetam versus Carbamazepine for Epilepsy: A Meta-Analysis

Abstract

Leviteracetam (LEV) is a novel antiepileptic drug with improved tolerance and safety, while carbamazepine (CBZ) represents classical antiepileptic drugs. So far, a systemic comparison of the efficacy and side effects of these two drugs is lacking. A literature review on the comparison of leviteracetam versus carbamazepine for patients with epilepsy was performed up to September 2013 using PubMed, EMBASE, the Cochrane Library and ISI web of science. Finally, 3 randomized controlled trials (RCT) studies met the criteria on comparing the efficacy of leviteracetam versus carbamazepine for patients with epilepsy were included for meta-analysis. Stata 11.0 was used to analyze and summarize the respective data. Three RCTs met the entry criteria. The relative risk (RR) and 95% and the confidence interval (CI) of leviteracetam versus carbamazepine for 6- and 12-month seizure free intervals were 1.0 (0.91-1.10) and 0.97 (0.84-1.13), respectively, for therapy discontinuation due to adverse events (AEs) were 0.62 (0.48-0.80) and 1.00 (0.94-2.05), respectively, and for withdrawal after 6- and 12-month treatment were 0.8 (0.64-0.99) and 0.87 (0.74-1.03), respectively. The RR and 95% CI for occurrence of headache, fatigue, diarrhea, vertigo, nasopharyngitis, depression, weight gain and rash were 0.88 (0.73-1.06), 1.08(0.63-1.83), 1.23 (0.66-2.28), 0.92 (0.49-1.71), 0.85 (0.59-1.22), 2.15 (1.26-3.68), 0.69 (0.45-1.04), 0.39 (0.23-0.68), respectively. The major outcomes such as rate of seizure freedom were similar between leviteracetam and carbamazepine. However, leviteracetam led to depression more frequently than carbamazepine, while carbamazepine caused rash more frequently. However, the limited numbers of available RCTs studies and included patients in this study made our results less convincing and accurate.