Topiramate (Epilepsy) updated on 04-22-2025

ASD (Autism spectrum disorder): Diagnosis/Risk

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.
S16763
R70393
Hernandez-Diaz, 2024 Autism spectrum disorder (ASD) - At least two visits with codes for ASD - Median follow-up was 2 years 2nd and/or 3rd trimester retrospective cohort (claims database) unexposed, sick Adjustment: Yes 0.75 [0.37;1.52] -/623   102/8,815 - 623
ref
S17437
R73276
Madley-Dowd_SE (Topiramate) (Controls exposed to LTG), 2024 Autism - ICD-8/9/10 codes - Mean 5-20 years old (according groups) during pregnancy (anytime or not specified) population based cohort retrospective exposed to other treatment, sick excluded Adjustment: No Partial overlapping 4.06 [1.68;9.78] C
excluded (control group)
6/71   53/2,383 59 71
ref
S17438
R73271
Madley-Dowd_SE (Topiramate) (Controls unexposed, sick), 2024 Autism - ICD-8/9/10 codes - Mean 5-20 years old (according groups) during pregnancy (anytime or not specified) population based cohort retrospective unexposed, sick Adjustment: Yes Partial overlapping 2.79 [1.23;6.30] 6/71   425/10,769 431 71
ref
S17255
R72254
Madley-Dowd_UK (Topiramate) (Controls unexposed, sick) (Epilepsy), 2024 Autism - ICD10 codes - Median follow up 5.41 (3.59-8.40) years old during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed, sick Adjustment: Yes 0.68 [0.08;5.36] -/43   78/4,075 - 43
ref
S15875
R65448
Dreier (Topiramate) (Epilepsy) (Controls exposed to LTG), 2023 Autism spectrum disorder - Corresponding ICD-10 F-chapter - Up to 22 years of age during pregnancy (anytime or not specified) population based cohort propective exposed to other treatment, sick excluded Adjustment: No 2.32 [1.10;4.88] C
excluded (control group)
8/290   64/5,288 72 290
ref
S15876
R65457
Dreier (Topiramate) (Epilepsy) (Controls unexposed, sick), 2023 Autism spectrum disorder - Corresponding ICD-10 F-chapter - Up to 22 years of age during pregnancy (anytime or not specified) population based cohort propective unexposed, sick Adjustment: Yes 1.93 [0.95;3.94] 8/290   323/22,203 331 290
ref
S9960
R48036
Bjørk (Topiramate) (Controls exposed to Lamotrigine, sick), 2018 Autistic traits at 18 months and/or at 36 months (M-CHAT <2/6 critical or <3/23 or SCQ >13) during pregnancy (anytime or not specified) population based cohort propective exposed to other treatment, sick excluded Adjustment: No 0.97 [0.10;9.00] C
excluded (control group)
1/6   13/76 14 6
ref
S9955
R48037
Bjørk (Topiramate) (Controls unexposed, disease free), 2018 Autistic traits at 18 months and/or at 36 months (M-CHAT <2/6 critical or <3/23 or SCQ >13) during pregnancy (anytime or not specified) population based cohort propective unexposed, disease free excluded Adjustment: No 1.99 [0.23;17.00] C
excluded (control group)
1/6   6,907/75,497 6,908 6
ref
S9957
R48038
Bjørk (Topiramate) (Controls unexposed, sick), 2018 Autistic traits at 18 months and/or at 36 months (M-CHAT <2/6 critical or <3/23 or SCQ >13) during pregnancy (anytime or not specified) population based cohort propective unexposed, sick Adjustment: No 1.81 [0.20;16.11] C 1/6   27/272 28 6
ref
S6183
R48028
Wood (Topiramate), 2015 Score >30 (CARS) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick Adjustment: No 17.00 [0.13;2166.90] C 0/1   0/9 0 1
ref
Total 6 studies 1.54 [0.85;2.78] 790 1,034
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 Hernandez-Diaz, 2024Hernandez-Diaz, 2024 0.75[0.37; 1.52]-62330%ROB confusion: moderateROB selection: moderateROB classification: moderateROB missing: criticalROB mesure: criticalROB reporting: moderate Madley-Dowd_SE (Topiramate) (Controls unexposed, sick), 2024Madley-Dowd_SE, 2024 1 2.79[1.23; 6.30]4317126%ROB confusion: moderateROB selection: lowROB classification: lowROB missing: lowROB mesure: criticalROB reporting: moderate Madley-Dowd_UK (Topiramate) (Controls unexposed, sick) (Epilepsy), 2024Madley-Dowd_UK, 2024 2 0.68[0.08; 5.36]-437%ROB confusion: moderateROB selection: lowROB classification: criticalROB missing: unclearROB mesure: criticalROB reporting: moderate Dreier (Topiramate) (Epilepsy) (Controls unexposed, sick), 2023Dreier, 2023 3 1.93[0.95; 3.94]33129029%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Bjørk (Topiramate) (Controls unexposed, sick), 2018Bjørk, 2018 4 1.81[0.20; 16.11]2866%ROB confusion: unclearROB selection: lowROB classification: lowROB missing: lowROB mesure: moderateROB reporting: moderate Wood (Topiramate), 2015Wood, 2015 5 17.00[0.13; 2166.90]011%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: criticalROB mesure: lowROB reporting: moderate Total (6 studies) I2 = 37% 1.54[0.85; 2.78]7901,0340.250.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Topiramate) (Controls unexposed, sick; 2: Topiramate) (Controls unexposed, sick) (Epilepsy; 3: Topiramate) (Epilepsy) (Controls unexposed, sick; 4: Topiramate) (Controls unexposed, sick; 5: Topiramate;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.54[0.85; 2.78]7901,03437%NAHernandez-Diaz, 2024 Madley-Dowd_SE (Topiramate) (Controls unexposed, sick), 2024 Madley-Dowd_UK (Topiramate) (Controls unexposed, sick) (Epilepsy), 2024 Dreier (Topiramate) (Epilepsy) (Controls unexposed, sick), 2023 Bjørk (Topiramate) (Controls unexposed, sick), 2018 Wood (Topiramate), 2015 6 case control studiescase control studies 0 Type of controls unexposed, sickunexposed, sick 1.48[0.81; 2.71]7901,03343%NAHernandez-Diaz, 2024 Madley-Dowd_SE (Topiramate) (Controls unexposed, sick), 2024 Madley-Dowd_UK (Topiramate) (Controls unexposed, sick) (Epilepsy), 2024 Dreier (Topiramate) (Epilepsy) (Controls unexposed, sick), 2023 Bjørk (Topiramate) (Controls unexposed, sick), 2018 5 exposed to other treatment, sickexposed to other treatment, sick 17.00[0.13; 2166.90]-1 -NAWood (Topiramate), 2015 1 Tags Adjustment   - No  - No 2.65[0.36; 19.38]2870%NABjørk (Topiramate) (Controls unexposed, sick), 2018 Wood (Topiramate), 2015 2   - Yes  - Yes 1.45[0.73; 2.89]7621,02757%NAHernandez-Diaz, 2024 Madley-Dowd_SE (Topiramate) (Controls unexposed, sick), 2024 Madley-Dowd_UK (Topiramate) (Controls unexposed, sick) (Epilepsy), 2024 Dreier (Topiramate) (Epilepsy) (Controls unexposed, sick), 2023 4 Partial overlappingPartial overlapping 2.79[1.23; 6.31]43171 -NAMadley-Dowd_SE (Topiramate) (Controls unexposed, sick), 2024 1 All studiesAll studies 1.54[0.85; 2.78]7901,03437%NAHernandez-Diaz, 2024 Madley-Dowd_SE (Topiramate) (Controls unexposed, sick), 2024 Madley-Dowd_UK (Topiramate) (Controls unexposed, sick) (Epilepsy), 2024 Dreier (Topiramate) (Epilepsy) (Controls unexposed, sick), 2023 Bjørk (Topiramate) (Controls unexposed, sick), 2018 Wood (Topiramate), 2015 60.250.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-5.86.22.9680.000Hernandez-Diaz, 2024Madley-Dowd_SE (Topiramate) (Controls unexposed, sick), 2024Madley-Dowd_UK (Topiramate) (Controls unexposed, sick) (Epilepsy), 2024Dreier (Topiramate) (Epilepsy) (Controls unexposed, sick), 2023Bjørk (Topiramate) (Controls unexposed, sick), 2018Wood (Topiramate), 2015

Asymetry test p-value = 0.7115 (by Egger's regression)

slope=0.2063 (0.5802); intercept=0.4500 (1.1331); t=0.3972; p=0.7115

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 9960, 9955, 15875, 17437

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.99[0.23; 17.00]6,9086 -NABjørk (Topiramate) (Controls unexposed, disease free), 2018 1 unexposed, sick controlsunexposed, sick controls 1.48[0.81; 2.71]9521,03343%NAHernandez-Diaz, 2024 Madley-Dowd_SE (Topiramate) (Controls unexposed, sick), 2024 Madley-Dowd_UK (Topiramate) (Controls unexposed, sick) (Epilepsy), 2024 Dreier (Topiramate) (Epilepsy) (Controls unexposed, sick), 2023 Bjørk (Topiramate) (Controls unexposed, sick), 2018 5 exposed to other treatment, sick controlsexposed to other treatment, sick controls 2.80[1.62; 4.84]1453680%NAMadley-Dowd_SE (Topiramate) (Controls exposed to LTG), 2024 Dreier (Topiramate) (Epilepsy) (Controls exposed to LTG), 2023 Bjørk (Topiramate) (Controls exposed to Lamotrigine, sick), 2018 Wood (Topiramate), 2015 40.510.01.0