Topiramate (All indications) updated on 04-22-2025

Microcephaly / Small head circumference for gestational age

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.
S16072
R66699
Christensen (Topiramate) (All indications) (Controls exposed to LTG), 2024 Microcephaly (z-score for head circumference ≤3rd percentile for gestational week, sex, and country (including newborns with congenital malformations)) during pregnancy (anytime or not specified) population based cohort retrospective exposed to other treatment, sick excluded Adjustment: No 1.42 [0.95;2.11] C
excluded (control group)
28/638   274/8,756 302 638
ref
S16040
R66579
Christensen (Topiramate) (All indications) (Controls unexposed, general population), 2024 Microcephaly (z-score for head circumference ≤3rd percentile for gestational week, sex, and country (including newborns with congenital malformations)) during pregnancy (anytime or not specified) population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes 1.35 [0.92;1.99] 28/638   134,023/4,467,848 134,051 638
ref
S10173
R37180
Blotière (Topiramate) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2019 Microcephaly (until 24 months of age, identifiable by: Q02; brain MRI; according to the EUROCAT definition) 1st trimester retrospective cohort (claims database) exposed to other treatment, sick excluded Adjustment: No 5.81 [0.36;92.98] C
excluded (control group)
1/517   1/2,997 2 517
ref
S10048
R36431
Blotière (Topiramate) (Controls unexposed NOS) (Mixed indications), 2019 Microcephaly (until 24 months of age, identifiable by: Q02; brain MRI; according to the EUROCAT definition) 1st trimester retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: No 9.00 [0.20;50.80] 1/517   438/1,875,733 439 517
ref
S8595
R28611
Veiby (Topiramate) (Controls unexposed, disease free) (Mixed indications), 2014 Small for gestational age head circumference at birth (< 2.5th percentile) throughout pregnancy population based cohort retrospective unexposed, disease free Adjustment: Yes 7.21 [3.23;16.10] 7/48   18,514/771,412 18,521 48
ref
Total 3 studies 3.61 [0.85;15.40] 153,011 1,203
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 Christensen (Topiramate) (All indications) (Controls unexposed, general population), 2024Christensen, 2024 1 1.35[0.92; 1.99]134,05163844%ROB confusion: criticalROB selection: lowROB classification: criticalROB missing: lowROB mesure: unclearROB reporting: moderate Blotière (Topiramate) (Controls unexposed NOS) (Mixed indications), 2019Blotière, 2019 2 9.00[0.20; 50.80]43951717%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Veiby (Topiramate) (Controls unexposed, disease free) (Mixed indications), 2014Veiby, 2014 3 7.21[3.23; 16.10]18,5214839%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: moderateROB mesure: moderateROB reporting: moderate Total (3 studies) I2 = 87% 3.61[0.85; 15.40]153,0111,2030.520.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Topiramate) (All indications) (Controls unexposed, general population; 2: Topiramate) (Controls unexposed NOS) (Mixed indications; 3: Topiramate) (Controls unexposed, disease free) (Mixed indications;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 3.61[0.85; 15.40]153,0111,20387%NAChristensen (Topiramate) (All indications) (Controls unexposed, general population), 2024 Blotière (Topiramate) (Controls unexposed NOS) (Mixed indications), 2019 Veiby (Topiramate) (Controls unexposed, disease free) (Mixed indications), 2014 3 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 3.61[0.85; 15.40]153,0111,20387%NAChristensen (Topiramate) (All indications) (Controls unexposed, general population), 2024 Blotière (Topiramate) (Controls unexposed NOS) (Mixed indications), 2019 Veiby (Topiramate) (Controls unexposed, disease free) (Mixed indications), 2014 3 Tags Adjustment   - No  - No 9.00[0.56; 143.44]439517 -NABlotière (Topiramate) (Controls unexposed NOS) (Mixed indications), 2019 1   - Yes  - Yes 3.00[0.58; 15.48]152,57268693%NAChristensen (Topiramate) (All indications) (Controls unexposed, general population), 2024 Veiby (Topiramate) (Controls unexposed, disease free) (Mixed indications), 2014 2 All studiesAll studies 3.61[0.85; 15.40]153,0111,20387%NAChristensen (Topiramate) (All indications) (Controls unexposed, general population), 2024 Blotière (Topiramate) (Controls unexposed NOS) (Mixed indications), 2019 Veiby (Topiramate) (Controls unexposed, disease free) (Mixed indications), 2014 30.520.01.0

Publication bias and p-hacking diagnosis

funnel plot

Funnel plot not drawn. Less than 3 points.

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

not enought points

p values plot

Funnel plot not drawn. Less than 3 points.

Sub-groups analysis using all included studies

excluded 10173, 16072

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 3.61[0.85; 15.40]153,0111,20387%NAChristensen (Topiramate) (All indications) (Controls unexposed, general population), 2024 Blotière (Topiramate) (Controls unexposed NOS) (Mixed indications), 2019 Veiby (Topiramate) (Controls unexposed, disease free) (Mixed indications), 2014 3 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.46[0.99; 2.17]3041,1550%NAChristensen (Topiramate) (All indications) (Controls exposed to LTG), 2024 Blotière (Topiramate) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2019 20.510.01.0