|
The Cochrane Collaboration
Cochrane Reviews |
| Explore | New + Updated | Other languages |
|
 |
Clobazam as an add-on in the management of refractory epilepsyMichael B, Marson AG
Bookmark this:
     more ...
SummaryClobazam as an add-on in the management of refractory epilepsyOnly four randomised controlled trials have been undertaken assessing add-on clobazam for refractory epilepsy. All are cross-over studies of short duration; they used differing designs and were of poor methodological quality. Results suggest that clobazam reduces seizure frequency for drug refractory partial epilepsy. There are limited and inconclusive data for generalized epilepsy. Cloabazam was also associated with adverse events.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2010 Issue 1, Copyright © 2010 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
This version first published online:
April 16. 2008 AbstractBackgroundEpilepsy effects approximately 1% of the population, with up to 30% of patients continuing to have seizures despite antiepileptic drug treatment. ObjectivesTo assess the efficacy and tolerability of clobazam when used as an add-on therapy for patients with refractory partial onset or generalised onset seizures. Search strategyWe searched the following on 22nd March 2007: (a) The Cochrane Epilepsy Group Specialised Register; (b) The Cochrane Central Register of Controlled Trials (CENTRAL); (c) MEDLINE; (d) EMBASE; (e) Database of Abstracts of Reviews of Effectiveness (DARE); (f) American College of Physicians Journals; (g) BIOSIS. Selection criteriaRandomised trials of add-on clobazam, with adequate methods of allocation concealment, recruiting patients with drug refractory partial or generalised onset seizures, with a minimum treatment period of eight weeks. Data collection and analysisTwo review authors independently selected trials for inclusion and extracted relevant data. The following outcomes were assessed: 50% or greater reduction in seizures; seizure freedom; treatment withdrawal and adverse effects. Main resultsFour cross-over studies, representing 196 participants, were included. However, due to significant methodological heterogeneity and differences in outcome measures it was not possible to summarise data in a meta-analysis. Only two of the studies reported a 50% or greater seizure reduction compared to placebo; 57.7% and 52.4%. Side effects were only described in two of the studies, reportedly present in 36% and 85% of patients. Authors' conclusionsClobazam as an add-on treatment may reduce seizure frequency and may be most effective in partial onset seizures. However, it is not clear who will best benefit and over what time-frame. A large scale, randomised controlled trial conducted over a greater period of time, incorporating subgroups with differing seizure types, is required to inform clinical practice. |