Dataset Information

Increased homocysteine levels in valproate-treated patients with epilepsy: a meta-analysis.

ABSTRACT:

Objective

To determine whether valproate (VPA) monotherapy influences homocysteine metabolism in patients with epilepsy.

Design

Systematic review and meta-analysis.

Data sources

We searched all articles in English through PubMed, Web of Science and EMBASE published up to August 2013 concerning the homocysteine levels in VPA monotherapeutic patients with epilepsy.

Participants

VPA-treated patients with epilepsy (n=266) and matched healthy controls (n=489).

Outcome measures

Heterogeneity between studies was assessed using I(2) statistics. Pooled standardised mean difference (SMD) and 95% CIs were calculated using a random effect model.

Results

A total of eight eligible studies were enrolled in our meta-analysis. We compared the plasma levels of homocysteine in VPA-treated patients with epilepsy and healthy controls. There was significant heterogeneity in the estimates according to the I(2) test (I(2)=65.6%, p=0.005). Plasma homocysteine levels in VPA-treated patients with epilepsy were significantly higher than in healthy controls under a random effect model. (SMD, 0.62; 95% CI 0.32 to 0.92). Further subgroup analyses suggested that no signi?cant differences were present when grouped by ethnicity and age, but the risk of heterogeneity in the West Asian group (I(2)=47.4%, p=0.107) was diminished when compared with that of the overall group (I(2)=65.6%, p=0.005).

Conclusions

Our meta-analysis indicates that VPA monotherapy is associated with the increase in plasma homocysteine levels in patients with epilepsy. Whether this association is influenced by ethnicity needs further research.

SUBMITTER: Ni G

PROVIDER: S-EPMC4120332 | biostudies-literature | 2014 Jul

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Increased homocysteine levels in valproate-treated patients with epilepsy: a meta-analysis.

Ni Guanzhong G Qin Jiaming J Fang Ziyan Z Chen Yishu Y Chen Ziyi Z Zhou Jueqian J Zhou Liemin L

BMJ open 20140716 7

<h4>Objective</h4>To determine whether valproate (VPA) monotherapy influences homocysteine metabolism in patients with epilepsy.<h4>Design</h4>Systematic review and meta-analysis.<h4>Data sources</h4>We searched all articles in English through PubMed, Web of Science and EMBASE published up to August 2013 concerning the homocysteine levels in VPA monotherapeutic patients with epilepsy.<h4>Participants</h4>VPA-treated patients with epilepsy (n=266) and matched healthy controls (n=489).<h4>Outcome ...[more]

PMID: 25031190

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Project description:Valproate is an anticonvulsant, which is also widely used for treating psychiatric disorders. Some clinical trials have demonstrated benefits of valproate augmentation therapy in schizophrenia. Previous meta-analysis showed inconsistent findings because of limited literature at that time. The aim of this study is to update the newer published data by conducting a meta-analysis of clinical efficacy of valproate augmentation therapy in patients with schizophrenia or schizoaffective disorder. Data sources include electronic research through platform of PubMed. Study eligibility criteria, participants, and interventions were as follows: the inclusion criteria included articles discussing comparisons of the treatment effect in schizophrenic patients treated with antipsychotic augmented with valproate and antipsychotics with/without placebo; articles on clinical trials in humans. The exclusion criteria were case reports or series and nonclinical trials. We compared the effect between antipsychotic treatment with valproate augmentation and antipsychotic monotherapy. Data from clinical trials were pooled by random-effects model, and possible confounding variables were examined through meta-regression and subgroup analysis. Data from 11 articles including 889 patients were included into current meta-analysis. We found patients treated with antipsychotics with valproate augmentation showed significantly more improvement in total psychopathology than those treated with antipsychotics only (P = 0.02). Results from open trials, but not from randomized controlled trials (P = 0.20), showed significant improvement (P = 0.01). In addition, the significance only persisted in the studies conducted with a shorter treatment duration (P < 0.001) rather than longer treatment duration (P = 0.23). There is no difference in the dropout rate between valproate augmentation and antipsychotic treatment only (P = 0.14). We could not perform a detailed meta-analysis for every category of antipsychotics, long-term effect, and safety profiles of valproate augmentation therapy in maintenance treatment, safety in pregnant patients, and subtype of schizophrenia. Our meta-analysis highlights the significantly better treatment effect with valproate augmentation therapy in patients with schizophrenia or schizoaffective disorder, and provides important evidence for supporting the practice of valproate augmentation therapy in these patients.

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Dataset Information

Increased homocysteine levels in valproate-treated patients with epilepsy: a meta-analysis.

Objective

Design

Data sources

Participants

Outcome measures

Results

Conclusions

Publications

Increased homocysteine levels in valproate-treated patients with epilepsy: a meta-analysis.

Similar Datasets

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