Lamotrigine (All indications)

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.
S8924
R48252		 Thomas (Lamotrigine) (Controls unexposed, sick), 2021 Skeletal malformations 1st trimester prospective cohort unexposed, sick Adjustment: No 1.36 [0.06;28.82] C 0/50   2/340 2 50
ref
S8969
R30375		 Ban (Lamotrigine) (Mixed indications), 2015 Limb anomaly 1st trimester prospective cohort unexposed (general population or NOS) Adjustment: No 1.50 [0.37;6.02] C 2/273   1,263/257,153 1,265 273
ref
S10292
R37691		 Vajda (Lamotrigine), 2013 Skeletal / Limb Malformations at least 1st trimester prospective cohort unexposed, sick Adjustment: No 0.15 [0.01;3.81] C 0/315   1/147 1 315
ref
S8909
R35289		 Mawer (Lamotrigine) (Controls unexposed, disease free), 2010 Skeletal / Limb Malformations 1st trimester prospective cohort unexposed, disease free excluded Adjustment: No Matched 24.04 [0.96;601.51] C
excluded (control group) 		1/37   0/285 1 37
ref
S8910
R35293		 Mawer (Lamotrigine) (Controls unexposed, sick), 2010 Skeletal / Limb Malformations 1st trimester prospective cohort unexposed, sick Adjustment: No Matched 3.42 [0.14;86.71] C 1/37   0/41 1 37
ref
Total 4 studies 1.24 [0.41;3.76] 1,269 675
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 (Lamotrigine) (Controls unexposed, sick), 2021Thomas, 2021 1 1.36[0.06; 28.82]25013%ROB confusion: seriousROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Ban (Lamotrigine) (Mixed indications), 2015Ban, 2015 2 1.50[0.37; 6.02]1,26527363%ROB confusion: criticalROB selection: moderateROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Vajda (Lamotrigine), 2013Vajda, 2013 3 0.15[0.01; 3.81]131512%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Mawer (Lamotrigine) (Controls unexposed, sick), 2010Mawer, 2010 4 3.42[0.14; 86.71]13712%ROB confusion: criticalROB selection: moderateROB classification: lowROB missing: moderateROB mesure: moderateROB reporting: moderate Total (4 studies) I2 = 0% 1.24[0.41; 3.76]1,2696750.010.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Lamotrigine) (Controls unexposed, sick; 2: Lamotrigine) (Mixed indications; 3: Lamotrigine; 4: Lamotrigine) (Controls unexposed, sick;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.24[0.41; 3.76]1,2696750%NAThomas (Lamotrigine) (Controls unexposed, sick), 2021 Ban (Lamotrigine) (Mixed indications), 2015 Vajda (Lamotrigine), 2013 Mawer (Lamotrigine) (Controls unexposed, sick), 2010 4 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.50[0.37; 6.02]1,265273 -NABan (Lamotrigine) (Mixed indications), 2015 1 unexposed, sickunexposed, sick 0.90[0.15; 5.60]44020%NAThomas (Lamotrigine) (Controls unexposed, sick), 2021 Vajda (Lamotrigine), 2013 Mawer (Lamotrigine) (Controls unexposed, sick), 2010 3 Tags Adjustment   - No  - No 1.24[0.41; 3.76]1,2696750%NAThomas (Lamotrigine) (Controls unexposed, sick), 2021 Ban (Lamotrigine) (Mixed indications), 2015 Vajda (Lamotrigine), 2013 Mawer (Lamotrigine) (Controls unexposed, sick), 2010 4 MatchedMatched 3.42[0.14; 86.71]137 -NAMawer (Lamotrigine) (Controls unexposed, sick), 2010 1 All studiesAll studies 1.24[0.41; 3.76]1,2696750%NAThomas (Lamotrigine) (Controls unexposed, sick), 2021 Ban (Lamotrigine) (Mixed indications), 2015 Vajda (Lamotrigine), 2013 Mawer (Lamotrigine) (Controls unexposed, sick), 2010 40.010.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-3.94.11.9790.000Thomas (Lamotrigine) (Controls unexposed, sick), 2021Ban (Lamotrigine) (Mixed indications), 2015Vajda (Lamotrigine), 2013Mawer (Lamotrigine) (Controls unexposed, sick), 2010

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 8909

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 4.04[0.30; 54.91]1,26631058%NABan (Lamotrigine) (Mixed indications), 2015 Mawer (Lamotrigine) (Controls unexposed, disease free), 2010 2 unexposed, sick controlsunexposed, sick controls 0.90[0.15; 5.60]44020%NAThomas (Lamotrigine) (Controls unexposed, sick), 2021 Vajda (Lamotrigine), 2013 Mawer (Lamotrigine) (Controls unexposed, sick), 2010 30.510.01.0

Umbrella review (other published meta-analyses)

Published MATE95% CIn exposedkI2Control groupExposition period WestonWeston Out of scale23.12[0.96; 558.25]NA-unexposed, disease freeduring pregnancy (anytime or not specified)studies1 WestonWeston 0.72[0.12; 4.12]40-unexposed, sickduring pregnancy (anytime or not specified)studies2 metaPregmetaPreg 1.24[0.41; 3.76]0%675--Thomas (Lamotrigine) (Controls unexposed, sick), 2021 Ban (Lamotrigine) (Mixed indications), 2015 Vajda (Lamotrigine), 2013 Mawer (Lamotrigine) (Controls unexposed, sick), 2010 40.510.01.0