Ethosuximide (Epilepsy)

Major congenital malformations

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.
S7792
R23010
Vajda (Ethosuximide) (Controls exposed to Lamotrigine, sick), 2019 Fetal malformations at least 1st trimester prospective cohort exposed to other treatment, sick excluded Adjustment: No 2.09 [0.11;40.14] C
excluded (control group)
0/5   20/406 20 5
ref
S7793
R23011
Vajda (Ethosuximide) (Controls unexposed, sick), 2019 Fetal malformations at least 1st trimester prospective cohort unexposed, sick Adjustment: No 3.44 [0.16;72.20] C 0/5   5/176 5 5
ref
S7645
R22621
Tomson (Ethosuximide), 2018 Malformed Offspring at least 1st trimester prospective cohort exposed to other treatment, sick Adjustment: No 1.42 [0.08;24.39] C 0/12   74/2,514 74 12
ref
S6495
R17815
Bànhidy (Ethosuximide), 2011 Total congenital abnormalities throughout pregnancy case control unexposed, sick Adjustment: No Matched 4.13 [0.18;96.94] C 2/2   12/22 14 2
ref
S6065
R15773
Morrow (Ethosuximide) (Controls exposed to Lamotrigine, sick), 2006 Major congenital malformation 1st trimester prospective cohort exposed to other treatment, sick excluded Adjustment: No 1.26 [0.07;22.17] C
excluded (control group)
0/12   21/647 21 12
ref
S6066
R15780
Morrow (Ethosuximide) (Controls unexposed, sick), 2006 Major congenital malformation 1st trimester prospective cohort unexposed, sick Adjustment: No 1.12 [0.06;20.58] C 0/12   8/227 8 12
ref
S6142
R16036
Kaaja (Ethosuximide), 2003 Major malformation 1st trimester prospective cohort unexposed, sick Adjustment: No 31.53 [1.02;978.23] C 0/2   2/239 2 2
ref
S6683
R18561
Dean (Ethosuximide), 2002 Major congenital malformations at least 1st trimester retrospective cohort unexposed, sick Adjustment: No 2.03 [0.08;51.22] C 0/4   2/38 2 4
ref
S6713
R18986
Samrén (Ethosuximide), 1999 Major congenial abnormalities at least 1st trimester retrospective cohort unexposed, disease free Adjustment: No Matched 3.93 [0.22;69.67] C 0/9   29/2,000 29 9
ref
Total 7 studies 3.13 [0.99;9.93] 134 46
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 Vajda (Ethosuximide) (Controls unexposed, sick), 2019Vajda, 2019 1 3.44[0.16; 72.20]5514%ROB confusion: criticalROB selection: moderateROB classification: lowROB missing: moderateROB mesure: moderateROB reporting: moderate Tomson (Ethosuximide), 2018Tomson, 2018 2 1.42[0.08; 24.39]741216%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Bànhidy (Ethosuximide), 2011Bànhidy, 2011 3 4.13[0.18; 96.94]14213%ROB confusion: criticalROB selection: criticalROB classification: lowROB missing: lowROB mesure: moderateROB reporting: moderate Morrow (Ethosuximide) (Controls unexposed, sick), 2006Morrow, 2006 4 1.12[0.06; 20.58]81216%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Kaaja (Ethosuximide), 2003Kaaja, 2003 5 31.53[1.02; 978.23]2211%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Dean (Ethosuximide), 2002Dean, 2002 6 2.03[0.08; 51.22]2413%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Samrén (Ethosuximide), 1999Samrén, 1999 7 3.93[0.22; 69.67]29916%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Total (7 studies) I2 = 0% 3.13[0.99; 9.93]134460.5100.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Ethosuximide) (Controls unexposed, sick; 2: Ethosuximide; 3: Ethosuximide; 4: Ethosuximide) (Controls unexposed, sick; 5: Ethosuximide; 6: Ethosuximide; 7: Ethosuximide;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 3.00[0.87; 10.37]120440%NAVajda (Ethosuximide) (Controls unexposed, sick), 2019 Tomson (Ethosuximide), 2018 Morrow (Ethosuximide) (Controls unexposed, sick), 2006 Kaaja (Ethosuximide), 2003 Dean (Ethosuximide), 2002 Samrén (Ethosuximide), 1999 6 case control studiescase control studies 4.13[0.18; 96.94]142 -NABànhidy (Ethosuximide), 2011 1 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 3.93[0.22; 69.67]299 -NASamrén (Ethosuximide), 1999 1 unexposed, sickunexposed, sick 3.60[0.88; 14.67]31250%NAVajda (Ethosuximide) (Controls unexposed, sick), 2019 Bànhidy (Ethosuximide), 2011 Morrow (Ethosuximide) (Controls unexposed, sick), 2006 Kaaja (Ethosuximide), 2003 Dean (Ethosuximide), 2002 5 exposed to other treatment, sickexposed to other treatment, sick 1.42[0.08; 24.39]7412 -NATomson (Ethosuximide), 2018 1 Tags Adjustment   - No  - No 3.13[0.99; 9.93]134460%NAVajda (Ethosuximide) (Controls unexposed, sick), 2019 Tomson (Ethosuximide), 2018 Bànhidy (Ethosuximide), 2011 Morrow (Ethosuximide) (Controls unexposed, sick), 2006 Kaaja (Ethosuximide), 2003 Dean (Ethosuximide), 2002 Samrén (Ethosuximide), 1999 7 MatchedMatched 4.02[0.48; 33.67]43110%NABànhidy (Ethosuximide), 2011 Samrén (Ethosuximide), 1999 2 All studiesAll studies 3.13[0.99; 9.93]134460%NAVajda (Ethosuximide) (Controls unexposed, sick), 2019 Tomson (Ethosuximide), 2018 Bànhidy (Ethosuximide), 2011 Morrow (Ethosuximide) (Controls unexposed, sick), 2006 Kaaja (Ethosuximide), 2003 Dean (Ethosuximide), 2002 Samrén (Ethosuximide), 1999 70.5100.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-4.15.32.1030.000Vajda (Ethosuximide) (Controls unexposed, sick), 2019Tomson (Ethosuximide), 2018Bànhidy (Ethosuximide), 2011Morrow (Ethosuximide) (Controls unexposed, sick), 2006Kaaja (Ethosuximide), 2003Dean (Ethosuximide), 2002Samrén (Ethosuximide), 1999

Asymetry test p-value = 0.0563 (by Egger's regression)

slope=-10.0399 (4.5306); intercept=7.1972 (2.9101); t=2.4731; p=0.0563

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 6065, 7792

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 3.93[0.22; 69.67]299 -NASamrén (Ethosuximide), 1999 1 unexposed, sick controlsunexposed, sick controls 3.60[0.88; 14.67]31250%NAVajda (Ethosuximide) (Controls unexposed, sick), 2019 Bànhidy (Ethosuximide), 2011 Morrow (Ethosuximide) (Controls unexposed, sick), 2006 Kaaja (Ethosuximide), 2003 Dean (Ethosuximide), 2002 5 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.55[0.29; 8.17]115290%NAVajda (Ethosuximide) (Controls exposed to Lamotrigine, sick), 2019 Tomson (Ethosuximide), 2018 Morrow (Ethosuximide) (Controls exposed to Lamotrigine, sick), 2006 30.510.01.0