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Evidence summaries

Clobazam Monotherapy for Partial-Onset or Generalized-Onset Seizures

Clobazam might possibly not be more effective than carbamazepine for retention at 12 months in drug-naïve children with seizures but there might be a slight advantage of clobazam over phenytoin for retention at 6 months in adolescents and adults with neurocysticercosis in a single clinical trial each, although the evidence is insufficient. Level of evidence: "D"

Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment), imprecise results (few trials and patients) and indirectness (another trial included only patients with neurocysticercosis).

Summary

A Cochrane review [Abstract] 1 included 2 studies with a total of 163 subjects with epilepsy. One of the trials was an open-label trial. The studies did not report the preselected primary outcome measure and a meta-analysis was not possible. One study recruited children and adolescents (n=115) and another, open-label one (n=48), adolescents and adults with a solitary neurocysticercus granuloma. Regarding retention at 12 months, there was no evidence of a significant difference between clobazam and carbamazepine (RR 0.83, 95% CI 0.61 to 1.12; one trial, n=115). Clobazam led to better retention compared with phenytoin (RR 1.43, 95% CI 1.08 to 1.90; one study, n=48). It could not be determined whether participants receiving clobazam were less likely to discontinue it due to adverse effects as compared to phenytoin (RR 0.10, 95% CI 0.01 to 1.65; one study, n=48).

Clinical comments

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Date of latest search:

    References

    • Arya R, Anand V, Garg SK et al. Clobazam monotherapy for partial-onset or generalized-onset seizures. Cochrane Database Syst Rev 2014;10():CD009258. [PubMed]

Primary/Secondary Keywords