Levetiracetam (All indications)

Oro-facial clefts

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.
S10170
R46496		 Blotière (Levetiracetam) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2019 Oro-facial clefts 1st trimester retrospective cohort (claims database) exposed to other treatment, sick excluded Adjustment: No 1.29 [0.14;11.60] C
excluded (control group) 		1/579   4/2,997 5 579
ref
S10037
R46487		 Blotière (Levetiracetam) (Controls unexposed NOS) (Mixed indications), 2019 Oro-facial clefts 1st trimester retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: No 1.15 [0.16;8.19] C 1/579   2,815/1,875,733 2,816 579
ref
S9010
R30650		 Tomson (Levetiracetam), 2018 Cleft lip or palate at least 1st trimester prospective cohort exposed to other treatment, sick Adjustment: No 1.40 [0.15;13.48] C 1/599   3/2,514 4 599
ref
S8991
R30542		 Hernández-Díaz (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2012 Oral clefts 1st trimester prospective cohort exposed to other treatment, sick Adjustment: No Controls: mixed indications 0.23 [0.01;4.04] C 0/450   7/1,562 7 450
ref
S9002
R30577		 Morrow (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2006 Facial cleft 1st trimester prospective cohort exposed to other treatment, sick Adjustment: No 10.01 [0.40;252.84] C 0/22   1/647 1 22
ref
Total 4 studies 1.24 [0.37;4.19] 2,828 1,650
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 Blotière (Levetiracetam) (Controls unexposed NOS) (Mixed indications), 2019Blotière, 2019 1 1.15[0.16; 8.19]2,81657939%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Tomson (Levetiracetam), 2018Tomson, 2018 2 1.40[0.15; 13.48]459929%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Hernández-Díaz (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2012Hernández-Díaz, 2012 3 0.23[0.01; 4.04]745018%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: moderateROB mesure: moderateROB reporting: moderate Morrow (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2006Morrow, 2006 4 10.01[0.40; 252.84]12214%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Total (4 studies) I2 = 0% 1.24[0.37; 4.19]2,8281,6500.250.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Levetiracetam) (Controls unexposed NOS) (Mixed indications; 2: Levetiracetam; 3: Levetiracetam) (Controls exposed to Lamotrigine, sick; 4: Levetiracetam) (Controls exposed to Lamotrigine, sick;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.24[0.37; 4.19]2,8281,6500%NABlotière (Levetiracetam) (Controls unexposed NOS) (Mixed indications), 2019 Tomson (Levetiracetam), 2018 Hernández-Díaz (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2012 Morrow (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2006 4 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.15[0.16; 8.19]2,816579 -NABlotière (Levetiracetam) (Controls unexposed NOS) (Mixed indications), 2019 1 exposed to other treatment, sickexposed to other treatment, sick 1.34[0.20; 9.12]121,07132%NATomson (Levetiracetam), 2018 Hernández-Díaz (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2012 Morrow (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2006 3 Tags Adjustment   - No  - No 1.24[0.37; 4.19]2,8281,6500%NABlotière (Levetiracetam) (Controls unexposed NOS) (Mixed indications), 2019 Tomson (Levetiracetam), 2018 Hernández-Díaz (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2012 Morrow (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2006 4 Controls   - mixed indications  - mixed indications 0.23[0.01; 4.04]7450 -NAHernández-Díaz (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2012 1 All studiesAll studies 1.24[0.37; 4.19]2,8281,6500%NABlotière (Levetiracetam) (Controls unexposed NOS) (Mixed indications), 2019 Tomson (Levetiracetam), 2018 Hernández-Díaz (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2012 Morrow (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2006 40.150.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-3.94.11.9770.000Blotière (Levetiracetam) (Controls unexposed NOS) (Mixed indications), 2019Tomson (Levetiracetam), 2018Hernández-Díaz (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2012Morrow (Levetiracetam) (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 10170

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.15[0.16; 8.19]2,816579 -NABlotière (Levetiracetam) (Controls unexposed NOS) (Mixed indications), 2019 1 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.30[0.36; 4.61]171,6500%NABlotière (Levetiracetam) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2019 Tomson (Levetiracetam), 2018 Hernández-Díaz (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2012 Morrow (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2006 40.510.01.0