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      Efficacy and Safety of Sodium Valproate Combined with Lamotrigine in Epilepsy: a Meta Analysis

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          Abstract

          Objective: To systematically evaluate the overall efficacy and safety of sodium valproate (VPA) combined with lamotrigine (LTG) in epilepsy, so as to provide evidence-based reference for the combined medication for the disease.

          Methods: We did a literature review of PubMed, Cochrane Library, EMBase, Wanfang Data, VIP, CNKI and CBM to identify studies published as of December 2015, in which randomized controlled trials (RTCs) of evaluating the efficacy and safety of VPA combined with LTG for patients with epilepsy were reported. We extracted the data of the articles′ first author, time of publication, sample size, patients′ age, medication, course of treatment, type of epilepsy, observation indexes and so on. The modified Jadad scale was used to assess the methodological quality of the included articles.

          Results: A total of 16 articles were included, including 15 in Chinese and one in English, involving 1 687 patients. The methodological quality of the included articles was unsatisfactory due to unknown risks existing in the allocation concealment, blind method, and selective reporting. Results of meta-analysis showed that the efficacy of VPA combined with LTG was significantly better than that of VPA [OR=5.76, 95%CI (3.78, 8.78), P<0.001] or that of LTG [OR=2.80, 95%CI (1.83, 4.28), P<0.001], while the adverse reactions in nervous system [RD= -0.04, 95%CI (-0.06, -0.02), P=0.002], digestive system [RD=-0.05, 95%CI (-0.08, -0.02)], blood system [RD= -0.03, 95%CI (-0.05, -0.01), P=0.040], and skin attachment system [RD= -0.04, 95%CI (-0.06, -0.01), P=0.008] were less compared with those of VPA or LTG.

          Conclusion: The effect of VPA combined with LTG is better than VPA or LTG along in epilepsy, and it has good tolerance. Due to limitations related to methodology of included studies, large-scale and high-quality RCTs are required for further validation of the conclusion.

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          Author and article information

          Journal
          CGP
          Chinese General Practice
          Compuscript (Ireland )
          1007-9572
          15 October 2017
          15 October 2017
          : 20
          : 29
          Affiliations
          [1] 1College of Pharmacy, Shihezi University, Shihezi 832002, China
          [2] 2The First Affiliated Hospital of the Medical College, Shihezi University, Shihezi 832002, China
          Author notes
          Corresponding author: ZHANG Yong-jun, Chief pharmacist; E-mail: zyjyjk@ 123456sina.com
          Article
          j.issn.1007-9572.2017.00.013
          10.3969/j.issn.1007-9572.2017.00.013
          80ac58af-f5a6-467a-a23f-8f4745f620a9
          © 2017 Chinese General Practice

          This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 Unported License (CC BY-NC 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc/4.0/.

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          Categories
          Abstract

          Endocrinology & Diabetes,General medicine,Occupational & Environmental medicine,Internal medicine,Health & Social care
          Valproic acid,Epilepsy,Drug toxicity,Lamotrigine,Drug synergism,Effectiveness,Meta-analysis

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