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Published on: May 16, 2019
Sulthiame add-on therapy for epilepsy
Philip Milburn-McNulty1, Graham Powell, Graeme J Sills
1The Walton Centre for Neurology & Neurosurgery NHS Trust, Liverpool, UK. philmilburnmcnulty@gmail.com.
The Cochrane Database of Systematic Reviews
|April 2, 2013
Summary
Sulthiame may help stop seizures in West syndrome when added to pyridoxine. However, the evidence is limited due to a small, biased study, necessitating further research for epilepsy treatment.
Area of Science:
- Neurology
- Clinical Pharmacology
Background:
- Epilepsy affects many, with 30% unresponsive to standard treatments.
- Sulthiame is an antiepileptic drug commonly used in Europe and Israel.
- Evidence for sulthiame's efficacy as an add-on therapy requires summarization.
Purpose of the Study:
- To evaluate sulthiame's effectiveness as an add-on therapy.
- To compare sulthiame's side-effect profile against placebo or other antiepileptics.
Main Methods:
- Searched Cochrane Epilepsy Group, CENTRAL, MEDLINE, and WHO IRCTRP up to August 2012.
- Included randomized placebo-controlled add-on trials of sulthiame for any epilepsy type.
- Assessed seizure frequency reduction, cessation, withdrawal rates, adverse effects, and quality of life.
Main Results:
- One trial with 37 West syndrome patients was included.
- Sulthiame, as add-on to pyridoxine, showed a risk ratio of 0.71 for seizure cessation (95% CI 0.53 to 0.96).
- Incomplete data prevented analysis of withdrawal times and adverse effects.
Conclusions:
- Sulthiame may induce seizure cessation in West syndrome when combined with pyridoxine.
- The single study's small size and high risk of bias limit current evidence.
- Further large, multi-center randomized controlled trials are essential to confirm sulthiame's role in epilepsy management.
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