A SYSTEMATIC REVIEW AND META-ANALYSIS ON THE EFFICACY OF LEVETIRACETAM COMPARED TO OTHER ANTIEPILEPTIC DRUGS IN THE MANAGEMENT OF REFRACTORY EPILEPSY IN ADULTS

Abstract

Approximately half of all epilepsy patients do not achieve control over epileptic seizures, as evident from the proper use of two or more antiepileptic drugs (AEDs). Levetiracetam stands out because of the special way it works, its safe pharmacokinetics, and its smooth tolerability in patients. Nonetheless, comparative evidence regarding its use in refractory epilepsy is still being worked out by meta-analytical studies. The purpose of this study was to assess how effective and safe Levetiracetam is as an AED in adults with refractory epilepsy, compared with other AEDs. A search of the literature was conducted on PubMed, Embase, Cochrane Library, and Scopus, following guidelines from the PRISMA statement. Eighteen studies were added (12 randomized controlled trials plus 6 observational studies), each involving more than 4,800 adult patients. Measures used included fewer seizures, seizure freedom, and better quality of life. Subgroup and sensitivity analysis was done using different drug types, doses, and how long treatment was given. Levetiracetam worked better than others to reduce the number of seizures (RR = 1.28; 95% CI: 1.12–1.45) and help patients remain seizure-free (RR = 1.34; 95% CI: 1.08–1.66). Health outcomes in terms of quality of life were somewhat better (SMD = 0.41; 95% CI: 0.19–0.62). In subgroup reviews, the advantages of these tablet medications were seen more clearly when taken for longer periods and at larger doses than with standard AEDs. Checking the results for sensitivity revealed strong findings. In adults with tough-to-treat epilepsy, levetiracetam works effectively and is considered equally or more effective than other epilepsy medicines. Because it is safe and useful in many diseases, it is often chosen as the main or supporting drug in tough cases of drug resistance