Effectiveness and safety of anti-seizure medications for refractory partial-onset seizures based on network Meta-analysis

Objective To assess the effectiveness and safety of anti-seizure medication (ASMs) for refractory partial-onset seizures.Methods The PubMed, Embase and The Cochrane Library were searched to collect randomized controlled trials (RCTs) related to ASMs for refractory partial-onset seizures from the inception of the database to November 1, 2024.Results 56 literature were included, involving 57 RCTs and 15,667 patients. Network Meta-analysis showed that when compared with placebo, tiagabine [RR=3.43, 95%CI(1.91, 6.14)], topiramate [RR=2.61, 95%CI(2.11, 3.23)], levetiracetam [RR=2.28, 95%CI(1.84, 2.83)], zonisamide [RR=2.28, 95%CI(1.70, 3.08)], rufinamide [RR=2.28, 95%CI(1.24, 4.19)], oxcarbazepine [RR=2.10, 95%CI(1.61, 2.74)], vigabatrin [RR=2.06, 95%CI(1.28, 3.30)], gabapentin [RR=2.02, 95%CI(1.51, 2.70)], pregabalin [RR=2.00, 95%CI(1.60, 2.50)], cenobamate [RR=1.97, 95%CI(1.40, 2.76)], lamotrigine [RR=1.85, 95%CI(1.09, 3.12)], lacosamide [RR=1.78, 95%CI(1.51, 2.10)], eslicarbazepine acetate [RR=1.75, 95%CI(1.43, 2.14)] and brivaracetam [RR=1.74, 95%CI(1.37, 2.21)] showed statistically significant effectiveness in achieving a 50% response rate (P