PDF(Pubmed)
Abstract：
UNASSIGNED: Antiseizure medications (ASMs) are first line therapy for seizure disorders. Their effects on arrhythmias, especially the risk of arrhythmias associated with lacosamide (LCM), levetiracetam (LEV), and perampanel (PER), have been intensely investigated.
UNASSIGNED: We searched four databases (PubMed, EMBASE, Cochrane Library, and Web of Science) until August 6, 2023. We used a common effects model and reported data as pooled incidence with 95% CIs. Meta-analyses were conducted to elucidate the risk of arrhythmias with different drugs, and Egger\'s regression was performed to detect publication bias analysis.
UNASSIGNED: We included 11 clinical trials with 1,031 participants. The pooled incidence of arrhythmias in the LEV group was 0.005 (95% CI: 0.001-0.013), while it was 0.014 in the LCM group (95% CI: 0.003-0.030). Publication bias analyses indicated no significant bias in the LEV group (t = 0.02, df = 4, p-value = 0.9852) but a significant bias in the LCM group (t = 5.94, df = 3, p-value = 0.0095). We corrected for this bias in the LCM group using the trim-and-fill method, which yielded a similar pooled incidence of 0.0137 (95% CI: 0.0036-0.0280), indicating good reliability. Due to insufficient studies, we could not conduct a meta-analysis for PER, and we analyzed them in our systematic review.
UNASSIGNED: The use of LCM significantly elevated the risk of arrhythmias, while LEV had non-significant arrhythmogenic effects. As for the arrhythmogenic effects of PER, more clinical trials are needed in the future.
UNASSIGNED: We searched four databases (PubMed, EMBASE, Cochrane Library, and Web of Science) until August 6, 2023. We used a common effects model and reported data as pooled incidence with 95% CIs. Meta-analyses were conducted to elucidate the risk of arrhythmias with different drugs, and Egger\'s regression was performed to detect publication bias analysis.
UNASSIGNED: We included 11 clinical trials with 1,031 participants. The pooled incidence of arrhythmias in the LEV group was 0.005 (95% CI: 0.001-0.013), while it was 0.014 in the LCM group (95% CI: 0.003-0.030). Publication bias analyses indicated no significant bias in the LEV group (t = 0.02, df = 4, p-value = 0.9852) but a significant bias in the LCM group (t = 5.94, df = 3, p-value = 0.0095). We corrected for this bias in the LCM group using the trim-and-fill method, which yielded a similar pooled incidence of 0.0137 (95% CI: 0.0036-0.0280), indicating good reliability. Due to insufficient studies, we could not conduct a meta-analysis for PER, and we analyzed them in our systematic review.
UNASSIGNED: The use of LCM significantly elevated the risk of arrhythmias, while LEV had non-significant arrhythmogenic effects. As for the arrhythmogenic effects of PER, more clinical trials are needed in the future.
摘要：
■抗癫痫药物（ASM）是癫痫发作的一线疗法。它们对心律失常的影响，特别是与拉科沙胺（LCM）相关的心律失常风险，左乙拉西坦（LEV），和Perampanel(PER)，已经被深入调查了。
■我们搜索了四个数据库（PubMed，EMBASE,科克伦图书馆,和WebofScience)，直到2023年8月6日。我们使用了一个常见的效应模型，并报告了95%CI的合并发病率数据。进行了荟萃分析，以阐明不同药物的心律失常风险。并进行Egger回归分析以检测发表偏倚。
■我们纳入了11项临床试验，有1,031名参与者。LEV组心律失常的合并发生率为0.005（95％CI：0.001-0.013），而LCM组为0.014(95%CI:0.003-0.030)。发表偏倚分析显示LEV组无显著偏倚(t=0.02,df=4,p值=0.9852),而LCM组有显著偏倚(t=5.94,df=3,p值=0.0095)。我们使用修剪和填充方法纠正了LCM组中的这种偏差，得出类似的合并发生率为0.0137（95％CI：0.0036-0.0280），表明良好的可靠性。由于研究不足,我们无法对PER进行荟萃分析，我们在系统回顾中分析了它们。
■使用LCM显著提高了心律失常的风险，而LEV无明显的致心律失常作用。至于PER的致心律失常作用，未来需要更多的临床试验。
■我们搜索了四个数据库（PubMed，EMBASE,科克伦图书馆,和WebofScience)，直到2023年8月6日。我们使用了一个常见的效应模型，并报告了95%CI的合并发病率数据。进行了荟萃分析，以阐明不同药物的心律失常风险。并进行Egger回归分析以检测发表偏倚。
■我们纳入了11项临床试验，有1,031名参与者。LEV组心律失常的合并发生率为0.005（95％CI：0.001-0.013），而LCM组为0.014(95%CI:0.003-0.030)。发表偏倚分析显示LEV组无显著偏倚(t=0.02,df=4,p值=0.9852),而LCM组有显著偏倚(t=5.94,df=3,p值=0.0095)。我们使用修剪和填充方法纠正了LCM组中的这种偏差，得出类似的合并发生率为0.0137（95％CI：0.0036-0.0280），表明良好的可靠性。由于研究不足,我们无法对PER进行荟萃分析，我们在系统回顾中分析了它们。
■使用LCM显著提高了心律失常的风险，而LEV无明显的致心律失常作用。至于PER的致心律失常作用，未来需要更多的临床试验。
