Lamotrigine (Epilepsy) updated on 04-22-2025

ASD (Autism spectrum disorder): Diagnosis

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.
S16762
R70390
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 0.93 [0.60;1.44] 32/3,134   102/8,815 134 3,134
ref
S17430
R73213
Madley-Dowd_SE (Lamotrigine) (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 0.81 [0.60;1.09] 53/2,383   425/10,769 478 2,383
ref
S17251
R72204
Madley-Dowd_UK (Lamotrigine) (Epilepsy), 2024 Autism - ICD10 codes - Median 6.18 (3.53-9.94) years old during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed, sick Adjustment: Yes 1.07 [0.62;1.85] 17/791   78/4,075 95 791
ref
S15870
R65387
Dreier, 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 0.86 [0.65;1.14] 64/5,288   323/22,203 387 5,288
ref
S6604
R35206
Bromley (Controls unexposed, disease free), 2013 Autistic Spectrum Disorders (at 6 years old) during pregnancy (anytime or not specified) prospective cohort unexposed, disease free excluded Adjustment: No 1.81 [0.20;16.76] C
excluded (control group)
1/30   4/214 5 30
ref
S6603
R35209
Bromley (Controls unexposed, sick), 2013 Autistic Spectrum Disorders (at 6 years old) during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: No 2.68 [0.10;68.88] C 1/30   0/26 1 30
ref
Total 5 studies 0.88 [0.73;1.04] 1,095 11,626
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 0.93[0.60; 1.44]1343,13416%ROB confusion: moderateROB selection: moderateROB classification: moderateROB missing: criticalROB mesure: criticalROB reporting: moderate Madley-Dowd_SE (Lamotrigine) (Controls unexposed, sick), 2024Madley-Dowd_SE, 2024 1 0.81[0.60; 1.09]4782,38334%ROB confusion: moderateROB selection: lowROB classification: lowROB missing: lowROB mesure: criticalROB reporting: moderate Madley-Dowd_UK (Lamotrigine) (Epilepsy), 2024Madley-Dowd_UK, 2024 2 1.07[0.62; 1.85]9579110%ROB confusion: moderateROB selection: lowROB classification: criticalROB missing: unclearROB mesure: criticalROB reporting: moderate Dreier, 2023Dreier, 2023 0.86[0.65; 1.14]3875,28839%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Bromley (Controls unexposed, sick), 2013Bromley, 2013 3 2.68[0.10; 68.88]1300%ROB confusion: criticalROB selection: lowROB classification: lowROB missing: moderateROB mesure: moderateROB reporting: moderate Total (5 studies) I2 = 0% 0.88[0.73; 1.04]1,09511,6260.210.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Lamotrigine) (Controls unexposed, sick; 2: Lamotrigine) (Epilepsy; 3: Controls unexposed, sick;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 0.88[0.73; 1.04]1,09511,6260%NAHernandez-Diaz, 2024 Madley-Dowd_SE (Lamotrigine) (Controls unexposed, sick), 2024 Madley-Dowd_UK (Lamotrigine) (Epilepsy), 2024 Dreier, 2023 Bromley (Controls unexposed, sick), 2013 5 case control studiescase control studies 0 Type of controls unexposed, sickunexposed, sick 0.88[0.73; 1.04]1,09511,6260%NAHernandez-Diaz, 2024 Madley-Dowd_SE (Lamotrigine) (Controls unexposed, sick), 2024 Madley-Dowd_UK (Lamotrigine) (Epilepsy), 2024 Dreier, 2023 Bromley (Controls unexposed, sick), 2013 5 Tags Adjustment   - No  - No 2.68[0.10; 68.88]130 -NABromley (Controls unexposed, sick), 2013 1   - Yes  - Yes 0.87[0.73; 1.04]1,09411,5960%NAHernandez-Diaz, 2024 Madley-Dowd_SE (Lamotrigine) (Controls unexposed, sick), 2024 Madley-Dowd_UK (Lamotrigine) (Epilepsy), 2024 Dreier, 2023 4 Partial overlappingPartial overlapping 0.81[0.60; 1.09]4782,383 -NAMadley-Dowd_SE (Lamotrigine) (Controls unexposed, sick), 2024 1 All studiesAll studies 0.88[0.73; 1.04]1,09511,6260%NAHernandez-Diaz, 2024 Madley-Dowd_SE (Lamotrigine) (Controls unexposed, sick), 2024 Madley-Dowd_UK (Lamotrigine) (Epilepsy), 2024 Dreier, 2023 Bromley (Controls unexposed, sick), 2013 50.210.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-3.93.81.9870.000Hernandez-Diaz, 2024Madley-Dowd_SE (Lamotrigine) (Controls unexposed, sick), 2024Madley-Dowd_UK (Lamotrigine) (Epilepsy), 2024Dreier, 2023Bromley (Controls unexposed, sick), 2013

Asymetry test p-value = 0.0517 (by Egger's regression)

slope=-0.3073 (0.0625); intercept=0.9808 (0.3125); t=3.1389; p=0.0517

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 6604

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.81[0.20; 16.76]530 -NABromley (Controls unexposed, disease free), 2013 1 unexposed, sick controlsunexposed, sick controls 0.88[0.73; 1.04]1,09511,6260%NAHernandez-Diaz, 2024 Madley-Dowd_SE (Lamotrigine) (Controls unexposed, sick), 2024 Madley-Dowd_UK (Lamotrigine) (Epilepsy), 2024 Dreier, 2023 Bromley (Controls unexposed, sick), 2013 50.510.01.0

Umbrella review (other published meta-analyses)

Published MAControlPeriodTE95% CIn exposedkI2 Veroniki (MA) (Autism Dyspraxia)Veroniki (MA) (Autism Dyspraxia) Out of scale13.77[2.06; 188.00]-Wwhatever (meta-analysis)T11st trimesterstudies TTT2 Veroniki (NMA) (Autism/Dyspraxia - Epilepsy only)Veroniki (NMA) (Autism/Dyspraxia - Epilepsy only) Out of scale10.24[1.25; 171.40]-Wwhatever (meta-analysis)Anyduring pregnancy (anytime or not specified)studies TTT-9 metaPregmetaPreg 0.88[0.73; 1.04]0%11,626----Hernandez-Diaz, 2024 Madley-Dowd_SE (Lamotrigine) (Controls unexposed, sick), 2024 Madley-Dowd_UK (Lamotrigine) (Epilepsy), 2024 Dreier, 2023 Bromley (Controls unexposed, sick), 2013 50.510.01.0