Levetiracetam (Epilepsy) updated on 04-22-2025

Psychomotor developmental disorders/delay

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.
S19435
R82823
Honybun (Controls exposed to LTG) (Levetiracetam) (Epilepsy), 2026 Processing Speed Index (Assesses psychomotor speed across time-based tasks) - Wechsler Intelligence Scale - Children aged 3–18 years (mean age about 10 years) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: No extrapolated (cont. endpoint) 2.62 [0.86;7.92]
excluded (control group)
-/20   -/23 - 20
ref
S19439
R82863
Honybun (Controls unexposed, sick) (Levetiracetam) (Epilepsy), 2026 Processing Speed Index (Assesses psychomotor speed across time-based tasks) - Wechsler Intelligence Scale - Children aged 3–18 years (mean age about 10 years) during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: No extrapolated (cont. endpoint) 3.56 [1.10;11.53] -/20   -/19 - 20
ref
S19454
R82923
Li (Controls exposed to LTG) (Levetiracetam) (Epilepsy), 2026 Manual dexterity and fine hand motor function - Grooved Pegboard Test (GPB) scores - Follow up to 6 years during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: No extrapolated (cont. endpoint) 1.12 [0.63;1.99]
excluded (control group)
-/67   -/90 - 67
ref
S19455
R82928
Li (Controls unexposed, disease free) (Levetiracetam) (Epilepsy), 2026 Manual dexterity and fine hand motor function - Grooved Pegboard Test (GPB) scores - Follow up to 6 years during pregnancy (anytime or not specified) prospective cohort unexposed, disease free Adjustment: No extrapolated (cont. endpoint) 1.09 [0.60;1.97] -/67   -/79 - 67
ref
S19458
R82951
Straub (Controls exposed to LTG) (Levetiracetam) (Epilepsy), 2026 Coordination disorders - ICD-10 codes: F82 - Mean follow up (full cohort): 3.4 years during pregnancy (anytime or not specified) retrospective cohort (claims database) exposed to other treatment, sick excluded Adjustment: No 1.00 [0.61;1.63] C
excluded (control group)
36/3,929   30/3,273 66 3,929
ref
S19468
R83037
Straub (Controls unexposed, sick) (Levetiracetam) (Epilepsy), 2026 Coordination disorders - ICD-10 codes: F82 - Mean follow up (full cohort): 3.4 years during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed, sick Adjustment: Yes 0.86 [0.57;1.31] 36/3,929   91/8,887 127 3,929
ref
S15842
R65225
Bromley (Levetiracetam) (Controls exposed to LTG), 2023 Motor mean score ≤ 86 (below average performance of the cohort mean) - Bayley Scales of Infant and Toddler Development - At 24 months of age during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: No 1.02 [0.31;3.43] C
excluded (control group)
5/51   7/73 12 51
ref
S15843
R65238
Bromley (Levetiracetam) (Controls unexposed, sick), 2023 Motor mean score ≤ 86 (below average performance of the cohort mean) - Bayley Scales of Infant and Toddler Development - At 24 months of age during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: No 1.20 [0.30;4.74] C 5/51   4/48 9 51
ref
S16783
R70457
Thomas (Controls exposed to LTG), 2022 Delayed motor development quotient (< 84, i.e one SD of the mean) - The developmental assessment scale for Indian infants (DASII) - Between 12-24 months of age (mean (SD): 15.3 (3.9) months)) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: No 0.41 [0.02;6.81] C
excluded (control group)
1/62   1/26 2 62
ref
S16784
R70458
Thomas (Controls unexposed, sick), 2022 The motor development quotient (MODQ) - The developmental assessment scale for Indian infants (DASII) - Between 12-24 months of age (mean (SD): 15.3 (3.9) months)) during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: No extrapolated (cont. endpoint) 0.24 [0.13;0.43] -/62   -/110 - 62
ref
S9949
R35785
Videman (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2016 Griffiths Mental Developmental Scale - Locomotor (at the age of 7 months) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: No extrapolated (cont. endpoint) 0.27 [0.04;1.85]
excluded (control group)
-/7   -/8 - 7
ref
S9951
R35797
Videman (Levetiracetam) (Controls unexposed, disease free), 2016 Griffiths Mental Developmental Scale - Locomotor (at the age of 7 months) during pregnancy (anytime or not specified) prospective cohort unexposed, disease free Adjustment: No extrapolated (cont. endpoint) 2.78 [0.66;11.65] -/7   -/59 - 7
ref
S6762
R19106
Shallcross (Levetiracetam), 2011 Locomotor (Griffiths scale) throughout pregnancy prospective cohort unexposed, disease free Adjustment: No extrapolated (cont. endpoint) 0.75 [0.41;1.39] -/51   -/97 - 51
ref
Total 7 studies 0.95 [0.53;1.71] 136 4,187
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 Honybun (Controls unexposed, sick) (Levetiracetam) (Epilepsy), 2026Honybun, 2026 1 3.56[1.10; 11.53]-2011%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: criticalROB mesure: lowROB reporting: moderate Li (Controls unexposed, disease free) (Levetiracetam) (Epilepsy), 2026Li, 2026 2 1.09[0.60; 1.97]-6717%ROB confusion: criticalROB selection: lowROB classification: unclearROB missing: moderateROB mesure: lowROB reporting: low Straub (Controls unexposed, sick) (Levetiracetam) (Epilepsy), 2026Straub, 2026 3 0.86[0.57; 1.31]1273,92919%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: unclearROB mesure: criticalROB reporting: moderate Bromley (Levetiracetam) (Controls unexposed, sick), 2023Bromley, 2023 4 1.20[0.30; 4.74]95110%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: moderateROB mesure: lowROB reporting: low Thomas (Controls unexposed, sick), 2022Thomas, 2022 5 0.24[0.13; 0.43]-6217%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: unclearROB mesure: lowROB reporting: moderate Videman (Levetiracetam) (Controls unexposed, disease free), 2016Videman, 2016 6 2.78[0.66; 11.65]-79%ROB confusion: unclearROB selection: lowROB classification: moderateROB missing: criticalROB mesure: lowROB reporting: moderate Shallcross (Levetiracetam), 2011Shallcross, 2011 7 0.75[0.41; 1.39]-5117%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Total (7 studies) I2 = 77% 0.95[0.53; 1.71]1364,1870.210.01.0ROB: A: confounding, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, sick) (Levetiracetam) (Epilepsy; 2: Controls unexposed, disease free) (Levetiracetam) (Epilepsy; 3: Controls unexposed, sick) (Levetiracetam) (Epilepsy; 4: Levetiracetam) (Controls unexposed, sick; 5: Controls unexposed, sick; 6: Levetiracetam) (Controls unexposed, disease free; 7: Levetiracetam;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 0.95[0.53; 1.71]1364,18777%NAHonybun (Controls unexposed, sick) (Levetiracetam) (Epilepsy), 2026 Li (Controls unexposed, disease free) (Levetiracetam) (Epilepsy), 2026 Straub (Controls unexposed, sick) (Levetiracetam) (Epilepsy), 2026 Bromley (Levetiracetam) (Controls unexposed, sick), 2023 Thomas (Controls unexposed, sick), 2022 Videman (Levetiracetam) (Controls unexposed, disease free), 2016 Shallcross (Levetiracetam), 2011 7 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.04[0.61; 1.75]-12531%NALi (Controls unexposed, disease free) (Levetiracetam) (Epilepsy), 2026 Videman (Levetiracetam) (Controls unexposed, disease free), 2016 Shallcross (Levetiracetam), 2011 3 unexposed, sickunexposed, sick 0.88[0.32; 2.41]1364,06286%NAHonybun (Controls unexposed, sick) (Levetiracetam) (Epilepsy), 2026 Straub (Controls unexposed, sick) (Levetiracetam) (Epilepsy), 2026 Bromley (Levetiracetam) (Controls unexposed, sick), 2023 Thomas (Controls unexposed, sick), 2022 4 Tags Adjustment   - No  - No 1.02[0.47; 2.23]925881%NAHonybun (Controls unexposed, sick) (Levetiracetam) (Epilepsy), 2026 Li (Controls unexposed, disease free) (Levetiracetam) (Epilepsy), 2026 Bromley (Levetiracetam) (Controls unexposed, sick), 2023 Thomas (Controls unexposed, sick), 2022 Videman (Levetiracetam) (Controls unexposed, disease free), 2016 Shallcross (Levetiracetam), 2011 6   - Yes  - Yes 0.86[0.57; 1.30]1273,929 -NAStraub (Controls unexposed, sick) (Levetiracetam) (Epilepsy), 2026 1 extrapolated (cont. endpoint)extrapolated (cont. endpoint) 1.01[0.42; 2.42]-20784%NAHonybun (Controls unexposed, sick) (Levetiracetam) (Epilepsy), 2026 Li (Controls unexposed, disease free) (Levetiracetam) (Epilepsy), 2026 Thomas (Controls unexposed, sick), 2022 Videman (Levetiracetam) (Controls unexposed, disease free), 2016 Shallcross (Levetiracetam), 2011 5 All studiesAll studies 0.95[0.53; 1.71]1364,18777%NAHonybun (Controls unexposed, sick) (Levetiracetam) (Epilepsy), 2026 Li (Controls unexposed, disease free) (Levetiracetam) (Epilepsy), 2026 Straub (Controls unexposed, sick) (Levetiracetam) (Epilepsy), 2026 Bromley (Levetiracetam) (Controls unexposed, sick), 2023 Thomas (Controls unexposed, sick), 2022 Videman (Levetiracetam) (Controls unexposed, disease free), 2016 Shallcross (Levetiracetam), 2011 70.110.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-1.71.70.8790.000Honybun (Controls unexposed, sick) (Levetiracetam) (Epilepsy), 2026Li (Controls unexposed, disease free) (Levetiracetam) (Epilepsy), 2026Straub (Controls unexposed, sick) (Levetiracetam) (Epilepsy), 2026Bromley (Levetiracetam) (Controls unexposed, sick), 2023Thomas (Controls unexposed, sick), 2022Videman (Levetiracetam) (Controls unexposed, disease free), 2016Shallcross (Levetiracetam), 2011

Asymetry test p-value = 0.3147 (by Egger's regression)

slope=-0.9276 (0.6648); intercept=2.1887 (1.9591); t=1.1172; p=0.3147

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 9949, 16783, 15842, 19435, 19454, 19458

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.04[0.61; 1.75]-12531%NALi (Controls unexposed, disease free) (Levetiracetam) (Epilepsy), 2026 Videman (Levetiracetam) (Controls unexposed, disease free), 2016 Shallcross (Levetiracetam), 2011 3 unexposed, sick controlsunexposed, sick controls 0.88[0.32; 2.41]1364,06286%NAHonybun (Controls unexposed, sick) (Levetiracetam) (Epilepsy), 2026 Straub (Controls unexposed, sick) (Levetiracetam) (Epilepsy), 2026 Bromley (Levetiracetam) (Controls unexposed, sick), 2023 Thomas (Controls unexposed, sick), 2022 4 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.08[0.77; 1.50]804,1361%NAHonybun (Controls exposed to LTG) (Levetiracetam) (Epilepsy), 2026 Li (Controls exposed to LTG) (Levetiracetam) (Epilepsy), 2026 Straub (Controls exposed to LTG) (Levetiracetam) (Epilepsy), 2026 Bromley (Levetiracetam) (Controls exposed to LTG), 2023 Thomas (Controls exposed to LTG), 2022 Videman (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2016 60.510.01.0