Ethosuximide (Epilepsy) updated on 04-22-2025

Major congenital malformations

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.
S16706
R70289		 Battino, 2024 Major congenital malformations (MCMs) early pregnancy prospective cohort exposed to other treatment, sick Adjustment: No 0.90 [0.05;15.03] C 0/18   110/3,584 110 18
ref
S7792
R23010		 Vajda (Ethosuximide) (Controls exposed to Lamotrigine, sick), 2019 Fetal malformations at least 1st trimester prospective cohort exposed to other treatment, sick excluded Adjustment: No 2.09 [0.11;40.14] C
excluded (control group) 		0/5   20/406 20 5
ref
S7793
R23011		 Vajda (Ethosuximide) (Controls unexposed, sick), 2019 Fetal malformations at least 1st trimester prospective cohort unexposed, sick Adjustment: No 3.44 [0.16;72.20] C 0/5   5/176 5 5
ref
S6495
R17815		 Bànhidy (Ethosuximide), 2011 Total congenital abnormalities throughout pregnancy case control unexposed, sick Adjustment: No Matched 4.13 [0.18;96.94] C 2/2   12/22 14 2
ref
S6065
R15773		 Morrow (Ethosuximide) (Controls exposed to Lamotrigine, sick), 2006 Major congenital malformation 1st trimester prospective cohort exposed to other treatment, sick excluded Adjustment: No 1.26 [0.07;22.17] C
excluded (control group) 		0/12   21/647 21 12
ref
S6066
R15780		 Morrow (Ethosuximide) (Controls unexposed, sick), 2006 Major congenital malformation 1st trimester prospective cohort unexposed, sick Adjustment: No 1.12 [0.06;20.58] C 0/12   8/227 8 12
ref
S6142
R16036		 Kaaja (Ethosuximide), 2003 Major malformation 1st trimester prospective cohort unexposed, sick Adjustment: No 31.53 [1.02;978.23] C 0/2   2/239 2 2
ref
S6683
R18561		 Dean (Ethosuximide), 2002 Major congenital malformations at least 1st trimester retrospective cohort unexposed, sick Adjustment: No 2.03 [0.08;51.22] C 0/4   2/38 2 4
ref
S6713
R18986		 Samrén (Ethosuximide), 1999 Major congenial abnormalities at least 1st trimester retrospective cohort unexposed, disease free Adjustment: No Matched 3.93 [0.22;69.67] C 0/9   29/2,000 29 9
ref
Total 7 studies 2.90 [0.92;9.16] 170 52
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 Battino, 2024Battino, 2024 0.90[0.05; 15.03]1101817%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: moderateROB mesure: moderateROB reporting: moderate Vajda (Ethosuximide) (Controls unexposed, sick), 2019Vajda, 2019 1 3.44[0.16; 72.20]5514%ROB confusion: criticalROB selection: moderateROB classification: lowROB missing: moderateROB mesure: moderateROB reporting: moderate Bànhidy (Ethosuximide), 2011Bànhidy, 2011 2 4.13[0.18; 96.94]14213%ROB confusion: criticalROB selection: criticalROB classification: lowROB missing: lowROB mesure: moderateROB reporting: moderate Morrow (Ethosuximide) (Controls unexposed, sick), 2006Morrow, 2006 3 1.12[0.06; 20.58]81216%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Kaaja (Ethosuximide), 2003Kaaja, 2003 4 31.53[1.02; 978.23]2211%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Dean (Ethosuximide), 2002Dean, 2002 5 2.03[0.08; 51.22]2413%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Samrén (Ethosuximide), 1999Samrén, 1999 6 3.93[0.22; 69.67]29916%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Total (7 studies) I2 = 0% 2.90[0.92; 9.16]170520.2100.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Ethosuximide) (Controls unexposed, sick; 2: Ethosuximide; 3: Ethosuximide) (Controls unexposed, sick; 4: Ethosuximide; 5: Ethosuximide; 6: Ethosuximide;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 2.74[0.80; 9.45]156500%NABattino, 2024 Vajda (Ethosuximide) (Controls unexposed, sick), 2019 Morrow (Ethosuximide) (Controls unexposed, sick), 2006 Kaaja (Ethosuximide), 2003 Dean (Ethosuximide), 2002 Samrén (Ethosuximide), 1999 6 case control studiescase control studies 4.13[0.18; 96.94]142 -NABànhidy (Ethosuximide), 2011 1 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 3.93[0.22; 69.67]299 -NASamrén (Ethosuximide), 1999 1 unexposed, sickunexposed, sick 3.60[0.88; 14.67]31250%NAVajda (Ethosuximide) (Controls unexposed, sick), 2019 Bànhidy (Ethosuximide), 2011 Morrow (Ethosuximide) (Controls unexposed, sick), 2006 Kaaja (Ethosuximide), 2003 Dean (Ethosuximide), 2002 5 exposed to other treatment, sickexposed to other treatment, sick 0.90[0.05; 15.03]11018 -NABattino, 2024 1 Tags Adjustment   - No  - No 2.90[0.92; 9.16]170520%NABattino, 2024 Vajda (Ethosuximide) (Controls unexposed, sick), 2019 Bànhidy (Ethosuximide), 2011 Morrow (Ethosuximide) (Controls unexposed, sick), 2006 Kaaja (Ethosuximide), 2003 Dean (Ethosuximide), 2002 Samrén (Ethosuximide), 1999 7 MatchedMatched 4.02[0.48; 33.67]43110%NABànhidy (Ethosuximide), 2011 Samrén (Ethosuximide), 1999 2 All studiesAll studies 2.90[0.92; 9.16]170520%NABattino, 2024 Vajda (Ethosuximide) (Controls unexposed, sick), 2019 Bànhidy (Ethosuximide), 2011 Morrow (Ethosuximide) (Controls unexposed, sick), 2006 Kaaja (Ethosuximide), 2003 Dean (Ethosuximide), 2002 Samrén (Ethosuximide), 1999 70.2100.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-4.15.22.1030.000Battino, 2024Vajda (Ethosuximide) (Controls unexposed, sick), 2019Bànhidy (Ethosuximide), 2011Morrow (Ethosuximide) (Controls unexposed, sick), 2006Kaaja (Ethosuximide), 2003Dean (Ethosuximide), 2002Samrén (Ethosuximide), 1999

Asymetry test p-value = 0.0418 (by Egger's regression)

slope=-11.2080 (4.5227); intercept=7.9096 (2.9091); t=2.7189; p=0.0418

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 6065, 7792

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 3.93[0.22; 69.67]299 -NASamrén (Ethosuximide), 1999 1 unexposed, sick controlsunexposed, sick controls 3.60[0.88; 14.67]31250%NAVajda (Ethosuximide) (Controls unexposed, sick), 2019 Bànhidy (Ethosuximide), 2011 Morrow (Ethosuximide) (Controls unexposed, sick), 2006 Kaaja (Ethosuximide), 2003 Dean (Ethosuximide), 2002 5 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.32[0.25; 6.93]151350%NABattino, 2024 Vajda (Ethosuximide) (Controls exposed to Lamotrigine, sick), 2019 Morrow (Ethosuximide) (Controls exposed to Lamotrigine, sick), 2006 30.510.01.0