Greater Response to Placebo in Children Than in Adults A Systematic Review and Meta-Analysis in Drug-Resistant Partial Epilepsy 英文参考文献.docVIP

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Greater Response to Placebo in Children Than in Adults A Systematic Review and Meta-Analysis in Drug-Resistant Partial Epilepsy 英文参考文献.doc

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Greater Response to Placebo in Children Than in Adults A Systematic Review and Meta-Analysis in Drug-Resistant Partial Epilepsy 英文参考文献

o PL SMEDICINE GreaterResponsetoPlaceboinChildrenThanin Adults:ASystematicReviewandMeta-Analysis inDrug-ResistantPartialEpilepsy Sylvain Rheims1,2,Michel Cucherat3,Alexis Arzimanoglou2,4,Philippe Ryvlin1,2,5* 1DepartmentofFunctionalNeurologyandEpileptology,HospicesCivilsdeLyon,Lyon,France,2CTRSINSERM-IDEE,InstituteforChildrenandAdolescentswithEpilepsy, Hospices Civils de Lyon, Lyon, France, 3 Department of Clinical Pharmacology, EA 643, Lyon-1 University, Laennec Faculty of Medicine, Lyon, France, 4 Department of Epileptology,SleepandPediatricNeurophysiology,HospicesCivilsdeLyon,Lyon,France5INSERMU821,Lyon,France Funding:Theauthorsreceivedno specificfundingforthisstudy. ABSTRACT CompetingInterests:SRhas Background receivedspeakerfeesfromPfizer. MChasnoconflictofinterest.AA hasreceivedspeakerorconsultant feesfromPfizer,Sanofi-Aventis, GlaxoSmithKline(GSK),Jansen-Cilag, UCBPharma,EISAI,andValeant.PR hasreceivedspeakerfeesfrom Cyberonics,Eisai,GSK,Janssen-Cilag, Novartis,Pfizer,Sanofi-Synthelabo, andUCB;andconsultantfeesfrom Cyberonics,GSK,Janssen-Cilag, Novartis,Pfizer,UCB,andValeant. Despite guidelines establishing the need to perform comprehensive paediatric drug development programs, pivotal trials in children with epilepsy have been completed mostly inPhaseIVasapostapprovalreplicationofadultdata.However,ithasbeenshownthatthe treatment response in children can differ from that in adults. It has not been investigated whetherdifferencesindrugeffectbetweenadultsandchildrenmightoccurinthetreatmentof drug-resistantpartialepilepsy,althoughsuchdifferencesmayhaveasubstantialimpactonthe designandresultsofpaediatricrandomisedcontrolledtrials(RCTs). AcademicEditor:TerryKlassen, UniversityofAlberta,Canada MethodsandFindings ThreeelectronicdatabasesweresearchedforRCTsinvestigatinganyantiepilepticdrug(AED) in the add-on treatment of drug-resistant partial epilepsy in both children and adults. The treatmenteffectwascomparedbetweenthetwoagegroupsusingtheratiooftherelativerisk