Topiramate (Epilepsy) updated on 04-22-2025

Congenital heart defects

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.
S19432
R82799		 Seo (Topiramate) (Epilepsy), 2026 Congenital Heart Defects 1st trimester population based cohort retrospective unexposed, sick Adjustment: Yes 1.11 [0.47;2.63] -/-   -/- - -
ref
S12871
R48604		 Thomas (Topiramate) (Controls exposed to Lamotrigine, sick), 2021 Cardiac malformations 1st trimester prospective cohort exposed to other treatment, sick excluded Adjustment: No 1.90 [0.07;50.68] C
excluded (control group) 		0/9   1/50 1 9
ref
S12872
R48614		 Thomas (Topiramate) (Controls unexposed, sick), 2021 Cardiac malformations 1st trimester prospective cohort unexposed, sick Adjustment: No 2.05 [0.11;38.10] C 0/9   9/340 9 9
ref
S7662
R22677		 Tomson (Topiramate), 2018 Cardiac malformations at least 1st trimester prospective cohort exposed to other treatment, sick Adjustment: No 3.35 [0.96;11.71] C 3/152   15/2,514 18 152
ref
S9837
R37712		 Vajda (Topiramate) (Controls exposed to Lamotrigine, sick), 2013 Cardiac Malformations at least 1st trimester prospective cohort exposed to other treatment, sick excluded Adjustment: No 1.02 [0.05;20.14] C
excluded (control group) 		0/44   3/315 3 44
ref
S9838
R37716		 Vajda (Topiramate) (Controls unexposed, sick), 2013 Cardiac Malformations at least 1st trimester prospective cohort unexposed, sick Adjustment: No 1.11 [0.04;27.86] C 0/44   1/147 1 44
ref
S6061
R15760		 Morrow (Topiramate) (Controls exposed to Lamotrigine, sick), 2006 Cardiac 1st trimester prospective cohort exposed to other treatment, sick Adjustment: No 2.60 [0.14;49.43] C 0/28   4/647 4 28
ref
Total 5 studies 1.62 [0.84;3.13] 32 233
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 Seo (Topiramate) (Epilepsy), 2026Seo, 2026 1 1.11[0.47; 2.63]--58%ROB confusion: seriousROB selection: moderateROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Thomas (Topiramate) (Controls unexposed, sick), 2021Thomas, 2021 2 2.05[0.11; 38.10]995%ROB confusion: seriousROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Tomson (Topiramate), 2018Tomson, 2018 3 3.35[0.96; 11.71]1815228%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Vajda (Topiramate) (Controls unexposed, sick), 2013Vajda, 2013 4 1.11[0.04; 27.86]1444%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Morrow (Topiramate) (Controls exposed to Lamotrigine, sick), 2006Morrow, 2006 5 2.60[0.14; 49.43]4285%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Total (5 studies) I2 = 0% 1.62[0.84; 3.13]322330.510.01.0ROB: A: confounding, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Topiramate) (Epilepsy; 2: Topiramate) (Controls unexposed, sick; 3: Topiramate; 4: Topiramate) (Controls unexposed, sick; 5: Topiramate) (Controls exposed to Lamotrigine, sick;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.62[0.84; 3.13]322330%NASeo (Topiramate) (Epilepsy), 2026 Thomas (Topiramate) (Controls unexposed, sick), 2021 Tomson (Topiramate), 2018 Vajda (Topiramate) (Controls unexposed, sick), 2013 Morrow (Topiramate) (Controls exposed to Lamotrigine, sick), 2006 5 case control studiescase control studies 0 Type of controls unexposed, sickunexposed, sick 1.16[0.52; 2.59]10530%NASeo (Topiramate) (Epilepsy), 2026 Thomas (Topiramate) (Controls unexposed, sick), 2021 Vajda (Topiramate) (Controls unexposed, sick), 2013 3 exposed to other treatment, sickexposed to other treatment, sick 3.23[1.02; 10.20]221800%NATomson (Topiramate), 2018 Morrow (Topiramate) (Controls exposed to Lamotrigine, sick), 2006 2 Tags Adjustment   - No  - No 2.75[0.99; 7.59]322330%NAThomas (Topiramate) (Controls unexposed, sick), 2021 Tomson (Topiramate), 2018 Vajda (Topiramate) (Controls unexposed, sick), 2013 Morrow (Topiramate) (Controls exposed to Lamotrigine, sick), 2006 4   - Yes  - Yes 1.11[0.47; 2.63]-- -NASeo (Topiramate) (Epilepsy), 2026 1 All studiesAll studies 1.62[0.84; 3.13]322330%NASeo (Topiramate) (Epilepsy), 2026 Thomas (Topiramate) (Controls unexposed, sick), 2021 Tomson (Topiramate), 2018 Vajda (Topiramate) (Controls unexposed, sick), 2013 Morrow (Topiramate) (Controls exposed to Lamotrigine, sick), 2006 50.510.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-3.94.31.9710.000Seo (Topiramate) (Epilepsy), 2026Thomas (Topiramate) (Controls unexposed, sick), 2021Tomson (Topiramate), 2018Vajda (Topiramate) (Controls unexposed, sick), 2013Morrow (Topiramate) (Controls exposed to Lamotrigine, sick), 2006

Asymetry test p-value = 0.6064 (by Egger's regression)

slope=0.2091 (0.5501); intercept=0.4210 (0.7339); t=0.5736; p=0.6064

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 9837, 12871

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed, sick controlsunexposed, sick controls 1.16[0.52; 2.59]10530%NASeo (Topiramate) (Epilepsy), 2026 Thomas (Topiramate) (Controls unexposed, sick), 2021 Vajda (Topiramate) (Controls unexposed, sick), 2013 3 exposed to other treatment, sick controlsexposed to other treatment, sick controls 2.68[0.97; 7.43]262330%NAThomas (Topiramate) (Controls exposed to Lamotrigine, sick), 2021 Tomson (Topiramate), 2018 Vajda (Topiramate) (Controls exposed to Lamotrigine, sick), 2013 Morrow (Topiramate) (Controls exposed to Lamotrigine, sick), 2006 40.510.01.0