Topiramate (Epilepsy)

Limb 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.
S12871
R48607		 Thomas (Topiramate) (Controls exposed to Lamotrigine, sick), 2021 Skeletal malformations 1st trimester prospective cohort exposed to other treatment, sick excluded Adjustment: No 5.82 [0.11;313.84] C
excluded (control group) 		0/9   0/50 0 9
ref
S12872
R48617		 Thomas (Topiramate) (Controls unexposed, sick), 2021 Skeletal malformations 1st trimester prospective cohort unexposed, sick Adjustment: No 7.94 [0.35;178.37] C 0/9   2/340 2 9
ref
S9837
R37714		 Vajda (Topiramate) (Controls exposed to Lamotrigine, sick), 2013 Skeletal / Limb Malformations at least 1st trimester prospective cohort exposed to other treatment, sick excluded Adjustment: No 7.23 [0.14;369.08] C
excluded (control group) 		0/44   0/315 0 44
ref
S9838
R37718		 Vajda (Topiramate) (Controls unexposed, sick), 2013 Skeletal / Limb 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
R15763		 Morrow (Topiramate) (Controls exposed to Lamotrigine, sick), 2006 Skeletal abnormalities 1st trimester prospective cohort exposed to other treatment, sick Adjustment: No 4.69 [0.22;100.00] C 0/28   2/647 2 28
ref
Total 3 studies 3.56 [0.59;21.68] 5 81
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 Thomas (Topiramate) (Controls unexposed, sick), 2021Thomas, 2021 1 7.94[0.35; 178.37]2934%ROB confusion: seriousROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Vajda (Topiramate) (Controls unexposed, sick), 2013Vajda, 2013 2 1.11[0.04; 27.86]14431%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Morrow (Topiramate) (Controls exposed to Lamotrigine, sick), 2006Morrow, 2006 3 4.69[0.22; 100.00]22835%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Total (3 studies) I2 = 0% 3.56[0.59; 21.68]5810.520.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

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

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 3.56[0.59; 21.68]5810%NAThomas (Topiramate) (Controls unexposed, sick), 2021 Vajda (Topiramate) (Controls unexposed, sick), 2013 Morrow (Topiramate) (Controls exposed to Lamotrigine, sick), 2006 3 case control studiescase control studies 0 Type of controls unexposed, sickunexposed, sick 3.08[0.33; 28.81]3530%NAThomas (Topiramate) (Controls unexposed, sick), 2021 Vajda (Topiramate) (Controls unexposed, sick), 2013 2 exposed to other treatment, sickexposed to other treatment, sick 4.69[0.22; 100.00]228 -NAMorrow (Topiramate) (Controls exposed to Lamotrigine, sick), 2006 1 Tags Adjustment   - No  - No 3.56[0.59; 21.68]5810%NAThomas (Topiramate) (Controls unexposed, sick), 2021 Vajda (Topiramate) (Controls unexposed, sick), 2013 Morrow (Topiramate) (Controls exposed to Lamotrigine, sick), 2006 3 All studiesAll studies 3.56[0.59; 21.68]5810%NAThomas (Topiramate) (Controls unexposed, sick), 2021 Vajda (Topiramate) (Controls unexposed, sick), 2013 Morrow (Topiramate) (Controls exposed to Lamotrigine, sick), 2006 30.520.01.0

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 9837, 12871

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed, sick controlsunexposed, sick controls 3.08[0.33; 28.81]3530%NAThomas (Topiramate) (Controls unexposed, sick), 2021 Vajda (Topiramate) (Controls unexposed, sick), 2013 2 exposed to other treatment, sick controlsexposed to other treatment, sick controls 5.60[0.71; 44.19]2810%NAThomas (Topiramate) (Controls exposed to Lamotrigine, sick), 2021 Vajda (Topiramate) (Controls exposed to Lamotrigine, sick), 2013 Morrow (Topiramate) (Controls exposed to Lamotrigine, sick), 2006 30.510.01.0