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Wiley InterScience | |||||||||
  EpilepsiaVolume 48 Issue 6, Pages 1173 - 1178 Published Online: 5 Jun 2007 © 2010 International League Against Epilepsy Published on behalf of the International League Against Epilepsy (ILAE)
Abstract | References | Full Text: HTML, PDF (Size: 90K) | Related Articles | Citation Tracking  Brief Communication New Statistical Method for Analyzing Time to First Seizure: Example Using Data Comparing Carbamazepine and Valproate Monotherapy Copyright 2007 International League Against Epilepsy KEYWORDS Epilepsy • Carbamazepine • Sodium valproate ABSTRACTSummary: Introduction: Time to first seizure is a common outcome in antiepileptic drug (AED) studies. Previous studies have typically failed to find statistically significant differences between carbamazepine (CBZ) and valproate (VPS). We re-analyzed a meta-analysis comparing CBZ and VPS monotherapy with new powerful statistical methods that incorporate baseline seizure rate information. Methods: Individual patient data were available on 1,265 patients from a meta-analysis of five trials. The outcome measure was time to first seizure after randomization, adjusted for background variables and baseline seizure rate. Results: We found strong evidence of an interaction between treatment and epilepsy type, and between treatment and age. For generalized onset seizures, VPS was statistically significantly better than CBZ: VPS delayed the first seizure after treatment 58%, 52%, 44%, and 36% longer than CBZ for individuals aged 10, 20, 30, or 40, respectively. For partial onset seizures in individuals older than 30, CBZ was significantly better then VPS; CBZ delayed the time to first seizure by 9%, 25%, 44%, and 66% longer than VPS for individuals aged 20, 30, 40, or 50, respectively. Conclusion: The results show clear age-varying differences between the effectiveness of CBZ and VPS for generalized onset and partial onset seizures, which have not been identified in previous studies using standard statistical methods. In future trials of AED monotherapy or add-on where time to first or Nth seizure is an outcome, methodology that can incorporate baseline seizure rate information would allow more powerful comparisons between treatments or between treatment and placebo. Accepted December 18, 2006. | 
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