Abstract | BACKGROUND: OBJECTIVES: To assess the efficacy and tolerability of clobazam when used as an add-on therapy for patients with refractory partial onset or generalised onset seizures. SEARCH STRATEGY: We searched the following on 22nd March 2007: (a) The Cochrane Epilepsy Group Specialised Register; (b) The Cochrane Central Register of Controlled Trials (CENTRAL); (c) MEDLINE; (d) EMBASE; (e) Database of Abstracts of Reviews of Effectiveness (DARE); (f) American College of Physicians Journals; (g) BIOSIS. SELECTION CRITERIA: Randomised trials of add-on clobazam, with adequate methods of allocation concealment, recruiting patients with drug refractory partial or generalised onset seizures, with a minimum treatment period of eight weeks. DATA COLLECTION AND ANALYSIS: Two review authors independently selected trials for inclusion and extracted relevant data. The following outcomes were assessed: 50% or greater reduction in seizures; seizure freedom; treatment withdrawal and adverse effects. MAIN RESULTS: Four cross-over studies, representing 196 participants, were included. However, due to significant methodological heterogeneity and differences in outcome measures it was not possible to summarise data in a meta-analysis. Only two of the studies reported a 50% or greater seizure reduction compared to placebo; 57.7% and 52.4%. Side effects were only described in two of the studies, reportedly present in 36% and 85% of patients. AUTHORS' CONCLUSIONS:
Clobazam as an add-on treatment may reduce seizure frequency and may be most effective in partial onset seizures. However, it is not clear who will best benefit and over what time-frame. A large scale, randomised controlled trial conducted over a greater period of time, incorporating subgroups with differing seizure types, is required to inform clinical practice.
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Authors | B Michael, A G Marson |
Journal | The Cochrane database of systematic reviews
(Cochrane Database Syst Rev)
Issue 2
Pg. CD004154
(Apr 16 2008)
ISSN: 1469-493X [Electronic] England |
PMID | 18425899
(Publication Type: Journal Article, Review, Systematic Review)
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Chemical References |
- Anticonvulsants
- Benzodiazepines
- Clobazam
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Topics |
- Anticonvulsants
(administration & dosage, therapeutic use)
- Benzodiazepines
(administration & dosage, therapeutic use)
- Clobazam
- Epilepsy
(drug therapy)
- Humans
- Randomized Controlled Trials as Topic
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