{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T04:57:27Z","timestamp":1792299447224,"version":"4.4.0"},"reference-count":26,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2019,10,13]],"date-time":"2019-10-13T00:00:00Z","timestamp":1570924800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To estimate the comparative efficacy and safety of antiepileptic drugs (<jats:styled-content style=\"fixed-case\">AED<\/jats:styled-content>s) in the elderly with new\u2010onset epilepsy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We searched electronic databases for randomized controlled trials (<jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>s) of monotherapy <jats:styled-content style=\"fixed-case\">AED<\/jats:styled-content>s to treat epilepsy in elderly. The following outcomes were analyzed: seizure freedom and withdrawal from the study for any cause at 6 and 12\u00a0months; withdrawal from the study for any adverse event (<jats:styled-content style=\"fixed-case\">AE<\/jats:styled-content>) at 12\u00a0months; and occurrence of any <jats:styled-content style=\"fixed-case\">AE<\/jats:styled-content> at 12\u00a0months. Effect sizes were estimated by network meta\u2010analyses within a frequentist framework. The hierarchy of competing interventions was established using the surface under the cumulative ranking curve (<jats:styled-content style=\"fixed-case\">SUCRA<\/jats:styled-content>) and mean ranks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Five <jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>s (1425 patients) were included. Included <jats:styled-content style=\"fixed-case\">AED<\/jats:styled-content>s were carbamazepine immediate\u2010 and controlled\u2010release (<jats:styled-content style=\"fixed-case\">CBZ<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">IR<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> CBZ<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">CR<\/jats:styled-content>), gabapentin (<jats:styled-content style=\"fixed-case\">GBP<\/jats:styled-content>), lacosamide (<jats:styled-content style=\"fixed-case\">LCM<\/jats:styled-content>), lamotrigine (<jats:styled-content style=\"fixed-case\">LTG<\/jats:styled-content>), levetiracetam (<jats:styled-content style=\"fixed-case\">LEV<\/jats:styled-content>), phenytoin (<jats:styled-content style=\"fixed-case\">PHT<\/jats:styled-content>), and valproic acid (<jats:styled-content style=\"fixed-case\">VPA<\/jats:styled-content>). At the pairwise and network meta\u2010analyses, there were no differences in any of the comparison according to 6\u2010 and 12\u2010month seizure freedom. The treatment with <jats:styled-content style=\"fixed-case\">CBZ<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">IR<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">CBZ<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">CR<\/jats:styled-content> was associated with a higher risk of withdrawal than <jats:styled-content style=\"fixed-case\">LTG<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> LEV<\/jats:styled-content>, or <jats:styled-content style=\"fixed-case\">VPA<\/jats:styled-content>, and <jats:styled-content style=\"fixed-case\">CBZ<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">IR<\/jats:styled-content> had the overall highest probability of discontinuation across all <jats:styled-content style=\"fixed-case\">AED<\/jats:styled-content>s. According to <jats:styled-content style=\"fixed-case\">SUCRA<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> the following <\/jats:styled-content>had the greatest likelihood ranking best for seizure freedom at 6 and 12\u00a0months: LCM, LTG, and LEV. <jats:styled-content style=\"fixed-case\">CBZ<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">CR<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">CBZ<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">IR<\/jats:styled-content> had the highest probabilities of being worst for the 12\u2010month retention. <jats:styled-content style=\"fixed-case\">CBZ<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">IR<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> CBZ<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">CR,<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">GBP<\/jats:styled-content> had the highest probabilities of withdrawal from the study for <jats:styled-content style=\"fixed-case\">AE<\/jats:styled-content>s, <jats:styled-content>,<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">VPA<\/jats:styled-content> had the highest probability of being the best\u2010tolerated option.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Although no significant difference in efficacy was found across treatments, <jats:styled-content style=\"fixed-case\">LCM<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> LTG<\/jats:styled-content>, and <jats:styled-content style=\"fixed-case\">LEV<\/jats:styled-content> had the highest probability of ranking best for achieving seizure freedom. <jats:styled-content style=\"fixed-case\">CBZ<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">IR<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">CBZ<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">CR<\/jats:styled-content> showed a poor tolerability profile, leading to higher withdrawal rates compared to <jats:styled-content style=\"fixed-case\">LEV<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">VPA<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.16366","type":"journal-article","created":{"date-parts":[[2019,10,14]],"date-time":"2019-10-14T04:43:25Z","timestamp":1571028205000},"page":"2245-2254","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":81,"title":["Antiepileptic drug monotherapy for epilepsy in the elderly: A systematic review and network meta\u2010analysis"],"prefix":"10.1111","volume":"60","author":[{"given":"Simona","family":"Lattanzi","sequence":"first","affiliation":[{"name":"Neurological Clinic Department of Experimental and Clinical Medicine Marche Polytechnic University Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugen","family":"Trinka","sequence":"additional","affiliation":[{"name":"Department of Neurology Christian Doppler Klinik University Hospital Paracelsus Medical University Salzburg Austria"},{"name":"Institute of Public Health, Medical Decision Making and Health Technology Assessment University for Health Sciences, Medical Informatics and Technology UMIT Hall in Tyrol Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cinzia","family":"Del Giovane","sequence":"additional","affiliation":[{"name":"Institute of Primary Health Care (BIHAM) University of Bern Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaele","family":"Nardone","sequence":"additional","affiliation":[{"name":"Department of Neurology Christian Doppler Klinik University Hospital Paracelsus Medical University Salzburg Austria"},{"name":"Department of Neurology Franz Tappeiner Hospital Merano 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