Topiramate (All indications) updated on 04-22-2025

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.
S19362
R82075		 Seo (Topiramate) (Epilepsy), 2026 Limb defects 1st trimester population based cohort retrospective unexposed, sick Adjustment: Yes 3.50 [0.74;16.50] -/-   -/- - -
ref
S12873
R48627		 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
S12875
R48639		 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
S10297
R37723		 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
S10298
R37733		 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
S8569
R28513		 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 4 studies 3.53 [1.09;11.44] 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 Seo (Topiramate) (Epilepsy), 2026Seo, 2026 1 3.50[0.74; 16.50]--58%ROB confusion: seriousROB selection: moderateROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Thomas (Topiramate) (Controls unexposed, sick), 2021Thomas, 2021 2 7.94[0.35; 178.37]2914%ROB confusion: seriousROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Vajda (Topiramate) (Controls unexposed, sick), 2013Vajda, 2013 3 1.11[0.04; 27.86]14413%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Morrow (Topiramate) (Controls exposed to Lamotrigine, sick), 2006Morrow, 2006 4 4.69[0.22; 100.00]22815%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Total (4 studies) I2 = 0% 3.53[1.09; 11.44]5810.520.01.0ROB: 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) (Controls unexposed, sick; 4: Topiramate) (Controls exposed to Lamotrigine, sick;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 3.53[1.09; 11.44]5810%NASeo (Topiramate) (Epilepsy), 2026 Thomas (Topiramate) (Controls unexposed, sick), 2021 Vajda (Topiramate) (Controls unexposed, sick), 2013 Morrow (Topiramate) (Controls exposed to Lamotrigine, sick), 2006 4 case control studiescase control studies 0 Type of controls unexposed, sickunexposed, sick 3.36[0.94; 12.01]3530%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 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   - Yes  - Yes 3.50[0.74; 16.53]-- -NASeo (Topiramate) (Epilepsy), 2026 1 All studiesAll studies 3.53[1.09; 11.44]5810%NASeo (Topiramate) (Epilepsy), 2026 Thomas (Topiramate) (Controls unexposed, sick), 2021 Vajda (Topiramate) (Controls unexposed, sick), 2013 Morrow (Topiramate) (Controls exposed to Lamotrigine, sick), 2006 40.520.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-3.95.11.9710.000Seo (Topiramate) (Epilepsy), 2026Thomas (Topiramate) (Controls unexposed, sick), 2021Vajda (Topiramate) (Controls unexposed, sick), 2013Morrow (Topiramate) (Controls exposed to Lamotrigine, sick), 2006

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

not enought points

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 10297, 12873

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed, sick controlsunexposed, sick controls 3.36[0.94; 12.01]3530%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 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