Topiramate (Epilepsy) updated on 04-22-2025

Neuro-developmental disorders (as a whole)

R analysis
id Study   Lib. in paper Exposition period    Study type  Control type 
 
Tags OR 95%CI x1/n1 x0/n0 no cases no exposed ROB Ref.
S18729
R79660
Moore (Topiramate) (Epilepsy) (Controls exposed to LTG), 2025 Early childhood developmental concerns (any developmental concerns on any domain at the 27–30 month assessment offered to all children) during pregnancy (anytime or not specified) population based cohort retrospective exposed to other treatment, sick excluded Adjustment: No 0.98 [0.35;2.77] C
excluded (control group)
5/20   90/354 95 20
ref
S18728
R79657
Moore (Topiramate) (Epilepsy) (Controls unexposed, sick), 2025 Early childhood developmental concerns (any developmental concerns on any domain at the 27–30 month assessment offered to all children) during pregnancy (anytime or not specified) population based cohort retrospective unexposed, sick Adjustment: No Matched 1.08 [0.38;3.05] 5/20   47/200 52 20
ref
S12719
R47982
Bjørk (Topiramate) (Controls exposed to Lamotrigine, sick), 2022 Neurodevelopmental Disorder (ND): any diagnoses of autism spectrum disorder (F84.0, F84.1, F84.5) or intellectual disability (F70, F71, F72, F73) plus F84.3, F84.4, F84.8, F84.9, F79 - Median follow up topiramate 5.7 (2.9-9.1) years old during pregnancy (anytime or not specified) population based cohort retrospective exposed to other treatment, sick excluded Adjustment: No 2.61 [1.34;5.10] C
excluded (control group)
10/246   81/5,073 91 246
ref
S12720
R47985
Bjørk (Topiramate) (Controls unexposed NOS), 2022 Neurodevelopmental Disorder (ND): any diagnoses of autism spectrum disorder (F84.0, F84.1, F84.5) or intellectual disability (F70, F71, F72, F73) plus F84.3, F84.4, F84.8, F84.9, F79 - Median follow up topiramate 5.7 (2.9-9.1) years old during pregnancy (anytime or not specified) population based cohort retrospective unexposed (general population or NOS) excluded Adjustment: No 2.73 [1.45;5.14] C
excluded (control group)
10/246   68,295/4,463,879 68,305 246
ref
S12721
R47988
Bjørk (Topiramate) (Controls unexposed, sick), 2022 Neurodevelopmental Disorder (ND): any diagnoses of autism spectrum disorder (F84.0, F84.1, F84.5) or intellectual disability (F70, F71, F72, F73) plus F84.3, F84.4, F84.8, F84.9, F79 - Median follow up topiramate 5.7 (2.9-9.1) years old during pregnancy (anytime or not specified) population based cohort retrospective unexposed, sick Adjustment: Yes 2.13 [1.13;4.01] 10/246   443/21,634 453 246
ref
S6251
R16646
Arkilo (Topiramate), 2015 Abnormal development (At 2 years of age, assessed by developmental specialists) during pregnancy (anytime or not specified) retrospective cohort exposed to other treatment, sick Adjustment: No 2.87 [0.09;91.05] C 0/2   2/24 2 2
ref
Total 3 studies 1.79 [1.05;3.06] 507 268
x1: number of endpoints among exposed, n1: number of exposed; x0: number of endpoints among non exposed, n0: number of non exposed; C: calculated odds ratio from numbers of events and effectives

Forest plot

StudyTE95% CIn casesn exposedweightROBABCDEF Moore (Topiramate) (Epilepsy) (Controls unexposed, sick), 2025Moore, 2025 1 1.08[0.38; 3.05]522026%ROB confusion: criticalROB selection: lowROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: low Bjørk (Topiramate) (Controls unexposed, sick), 2022Bjørk, 2022 2 2.13[1.13; 4.01]45324671%ROB confusion: moderateROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Arkilo (Topiramate), 2015Arkilo, 2015 3 2.87[0.09; 91.05]222%ROB confusion: criticalROB selection: criticalROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Total (3 studies) I2 = 0% 1.79[1.05; 3.06]5072680.510.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Topiramate) (Epilepsy) (Controls unexposed, sick; 2: Topiramate) (Controls unexposed, sick; 3: Topiramate;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.79[1.05; 3.06]5072680%NAMoore (Topiramate) (Epilepsy) (Controls unexposed, sick), 2025 Bjørk (Topiramate) (Controls unexposed, sick), 2022 Arkilo (Topiramate), 2015 3 case control studiescase control studies 0 Type of controls unexposed, sickunexposed, sick 1.73[0.94; 3.20]50526616%NAMoore (Topiramate) (Epilepsy) (Controls unexposed, sick), 2025 Bjørk (Topiramate) (Controls unexposed, sick), 2022 2 exposed to other treatment, sickexposed to other treatment, sick 2.87[0.09; 91.05]22 -NAArkilo (Topiramate), 2015 1 Tags Adjustment   - No  - No 1.17[0.43; 3.17]54220%NAMoore (Topiramate) (Epilepsy) (Controls unexposed, sick), 2025 Arkilo (Topiramate), 2015 2   - Yes  - Yes 2.13[1.13; 4.01]453246 -NABjørk (Topiramate) (Controls unexposed, sick), 2022 1 MatchedMatched 1.08[0.38; 3.06]5220 -NAMoore (Topiramate) (Epilepsy) (Controls unexposed, sick), 2025 1 All studiesAll studies 1.79[1.05; 3.06]5072680%NAMoore (Topiramate) (Epilepsy) (Controls unexposed, sick), 2025 Bjørk (Topiramate) (Controls unexposed, sick), 2022 Arkilo (Topiramate), 2015 30.510.01.0

Publication bias and p-hacking diagnosis

funnel plot

Funnel plot not drawn. Less than 3 points.

Asymetry test p-value = NaN (by Egger's regression)

not enought points

p values plot

Funnel plot not drawn. Less than 3 points.

Sub-groups analysis using all included studies

excluded 12719, 12720, 18729

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 2.73[1.45; 5.14]68,305246 -NABjørk (Topiramate) (Controls unexposed NOS), 2022 1 unexposed, sick controlsunexposed, sick controls 1.73[0.94; 3.20]50526616%NAMoore (Topiramate) (Epilepsy) (Controls unexposed, sick), 2025 Bjørk (Topiramate) (Controls unexposed, sick), 2022 2 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.87[0.94; 3.75]18826819%NAMoore (Topiramate) (Epilepsy) (Controls exposed to LTG), 2025 Bjørk (Topiramate) (Controls exposed to Lamotrigine, sick), 2022 Arkilo (Topiramate), 2015 30.510.01.0