{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T22:29:23Z","timestamp":1790548163341,"version":"4.1.0"},"reference-count":44,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Pharmacother"],"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To compare the efficacy and safety of levetiracetam versus sodium valproate as antiseizure therapy in children with new-onset epilepsy or established status epilepticus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources:<\/jats:title>\n                    <jats:p>PubMed, Cochrane Library, Embase, and Scopus were searched from inception to March 2026, without language restriction, using combinations of \u201cepilepsy,\u201d \u201cstatus epilepticus,\u201d \u201cpediatric,\u201d \u201clevetiracetam,\u201d and \u201csodium valproate,\u201d with hand-searching of reference lists.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Selection and Data Extraction:<\/jats:title>\n                    <jats:p>Randomized controlled trials and cohort studies of levetiracetam versus sodium valproate in children (\u226418 years) were eligible. Two reviewers independently screened records, extracted data, and appraised quality (Cochrane RoB 2; Newcastle\u2013Ottawa Scale for the cohort study). Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using a random-effects Mantel-Haenszel model, with certainty graded by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Synthesis:<\/jats:title>\n                    <jats:p>Eight studies (7 randomized trials and 1 prospective cohort) were included. Levetiracetam and sodium valproate were comparably effective for seizure freedom (RR = 1.01; 95% CI = 0.93-1.10) and for failure to achieve seizure freedom (RR = 1.00; 95% CI = 0.73-1.36). Levetiracetam significantly reduced overall AEs (RR = 0.78; 95% CI = 0.68-0.89) and weight gain (RR = 0.22; 95% CI = 0.10-0.46), both high certainty. Behavioral changes (RR = 2.15; 95% CI = 0.81-5.70) and skin rash (RR = 1.01; 95% CI = 0.50-2.04) did not differ significantly.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance to Patient Care and Clinical Practice:<\/jats:title>\n                    <jats:p>This is among the first meta-analyses to pool pediatric data for these agents across both new-onset epilepsy and status epilepticus and to grade outcome certainty. The findings support levetiracetam as a preferred initial monotherapy when weight, tolerability, reproductive safety, or interaction risk is a priority, with behavioral monitoring during use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Levetiracetam and sodium valproate offer similar seizure control in pediatric epilepsy and status epilepticus, but levetiracetam has a more favorable safety profile, particularly for adverse effects and weight gain. High-quality pediatric trials with longer follow-up are needed to confirm the long-term efficacy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10600280261471544","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T04:49:49Z","timestamp":1786682989000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Efficacy and Safety of Levetiracetam Versus Sodium Valproate in Pediatric Epilepsy: A Systematic Review and Meta-analysis"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-6248-5023","authenticated-orcid":false,"given":"Zahabia","family":"Adnan","sequence":"first","affiliation":[{"name":"Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5835-9811","authenticated-orcid":false,"given":"Amna Amir","family":"Jalal","sequence":"additional","affiliation":[{"name":"Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah","family":"Hameed","sequence":"additional","affiliation":[{"name":"Department of Medicine, Sahiwal Medical College, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed Hassan","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanza","family":"Shakir","sequence":"additional","affiliation":[{"name":"Department of Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4229-777X","authenticated-orcid":false,"given":"Syed Ibad","family":"Hussain","sequence":"additional","affiliation":[{"name":"Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eisha","family":"Abid","sequence":"additional","affiliation":[{"name":"Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2930-8188","authenticated-orcid":false,"given":"Ahmed Asad","family":"Raza","sequence":"additional","affiliation":[{"name":"Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,13]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e318204a36a"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1157.1981.tb06159.x"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1157.1989.tb05316.x"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/eci.70139"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.4236\/ojem.2018.64011"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.14946"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.2147\/OAEM.S293258"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.2174\/157015909788848866"},{"key":"e_1_3_2_10_2","unstructured":"Sodium valproate. 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