The adverse event profile of levetiracetam: A meta-analysis on children and adults

Alberto Verrotti, Giovanni Prezioso, Fabiana Di Sabatino, Valentina Franco, Francesco Chiarelli, Gaetano Zaccara

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose To analyze the adverse events (AEs) significantly associated with levetiracetam (LEV) therapy through a meta-analysis of all available double-blind, randomized placebo-controlled trials (RCTs), performed in any age, gender, ethnic background and disease. General tolerability and study withdrawals due to AEs associated with LEV treatment were also investigated. In addition, a dose-effect responses relationship for all variables was assessed. Methods RCTs were identified searching Medline (PubMed), Embase and Cochrane CENTRAL for the words "Levetiracetam" and "randomized controlled trial", with different search strategies, setting the limits "humans" and "English". Very common and common AEs according to the summary of product characteristics were investigated. RevMan version 5.2 was used for the statistical analyses. Risk difference with 95% confidence intervals was used to investigate the association of any AEs and withdrawal with LEV. Results Twenty-six studies with 2832 patients were included in the RCTs analysis. Nasopharyngitis, somnolence, dizziness, nervousness/irritability and asthenia/fatigue were statistically significant associated with LEV. In addition, LEV was significantly associated with an increased risk of AEs-related withdrawals. No dose-response relationship was found for any of the assessed variables. Conclusions This first large meta-analysis suggests that participants were more likely to discontinue LEV than placebo. The AE profile confirmed that LEV is associated with few unfavorable sedative, vestibulocerebellar and behavioral effects, such as nervousness and irritability. However, there does not seem to be a clear dose-response relationship.

Original languageEnglish
Pages (from-to)49-55
Number of pages7
JournalSeizure
Volume31
DOIs
Publication statusPublished - Sep 1 2015

Keywords

  • Adverse events
  • Antiepileptic drug
  • Discontinuation
  • Levetiracetam
  • Meta-analysis
  • Tolerability

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

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