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

Intrauterine deaths (as a whole or unspecified)

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.
S16756
R70384		 Vajda a (Topiramate) (Controls exposed to LTG) (Epilepsy), 2024 Intra uterine foetal death (including both spontaneous abortions and stillbirths, but not elective termination) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: No 0.72 [0.09;5.75] C
excluded (control group) 		1/45   10/326 11 45
ref
S16204
R67134		 Vajda a (Topiramate) (Controls unexposed sick) (Epilepsy), 2024 Intra uterine foetal death (including both spontaneous abortions and stillbirths, but not elective termination) during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: No 10.24 [0.41;255.93] C 1/45   0/149 1 45
ref
S8564
R28485		 Meador (Topiramate) (Controls exposed to Lamotrigine, sick), 2020 Fetal loss (Spontaneous miscarriages and fetal death) 1st trimester prospective cohort exposed to other treatment, sick excluded Adjustment: No 2.84 [0.13;62.17] C
excluded (control group) 		0/6   3/113 3 6
ref
S8565
R28489		 Meador (Topiramate) (Controls unexposed, disease free), 2020 Fetal loss (Spontaneous miscarriages and fetal death) 1st trimester prospective cohort unexposed, disease free excluded Adjustment: No 19.18 [0.35;1060.61] C
excluded (control group) 		0/6   0/106 0 6
ref
S8566
R28493		 Meador (Topiramate) (Controls unexposed, sick), 2020 Fetal loss (Spontaneous miscarriages and fetal death) 1st trimester prospective cohort unexposed, sick Adjustment: No 2.64 [0.05;149.97] C 0/6   0/15 0 6
ref
S8578
R28537		 Trivedi (Topiramate) (Controls exposed to Lamotrigine, sick), 2018 Spontaneous fetal loss (both spontaneous abortion before 20 weeks of gestation and stillbirths occurring after 20 weeks of gestation) 1st trimester prospective cohort exposed to other treatment, sick excluded Adjustment: No 9.17 [1.91;43.94] C
excluded (control group) 		5/11   4/48 9 11
ref
S8579
R28538		 Trivedi (Topiramate) (Controls unexposed, sick), 2018 Spontaneous fetal loss (both spontaneous abortion before 20 weeks of gestation and stillbirths occurring after 20 weeks of gestation) 1st trimester prospective cohort unexposed, sick Adjustment: Yes 38.86 [5.02;301.19] 5/11   5/178 10 11
ref
S8554
R28460		 Arkilo (Topiramate), 2015 Unsuccessful pregnancies (miscarriages/stillbirths) during pregnancy (anytime or not specified) retrospective cohort exposed to other treatment, sick Adjustment: No 2.87 [0.09;91.05] C 0/2   2/24 2 2
ref
Total 4 studies 13.39 [3.16;56.70] 13 64
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 Vajda a (Topiramate) (Controls unexposed sick) (Epilepsy), 2024Vajda a, 2024 1 10.24[0.41; 255.93]14520%ROB confusion: criticalROB selection: criticalROB classification: unclearROB missing: unclearROB mesure: criticalROB reporting: moderate Meador (Topiramate) (Controls unexposed, sick), 2020Meador, 2020 2 2.64[0.05; 149.97]0613%ROB confusion: unclearROB selection: lowROB classification: lowROB missing: lowROB mesure: moderateROB reporting: low Trivedi (Topiramate) (Controls unexposed, sick), 2018Trivedi, 2018 3 38.86[5.02; 301.19]101150%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Arkilo (Topiramate), 2015Arkilo, 2015 4 2.87[0.09; 91.05]2217%ROB confusion: criticalROB selection: criticalROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Total (4 studies) I2 = 0% 13.39[3.16; 56.70]13640.9100.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

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

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 13.39[3.16; 56.70]13640%NAVajda a (Topiramate) (Controls unexposed sick) (Epilepsy), 2024 Meador (Topiramate) (Controls unexposed, sick), 2020 Trivedi (Topiramate) (Controls unexposed, sick), 2018 Arkilo (Topiramate), 2015 4 case control studiescase control studies 0 Type of controls unexposed, sickunexposed, sick 18.53[3.79; 90.73]11620%NAVajda a (Topiramate) (Controls unexposed sick) (Epilepsy), 2024 Meador (Topiramate) (Controls unexposed, sick), 2020 Trivedi (Topiramate) (Controls unexposed, sick), 2018 3 exposed to other treatment, sickexposed to other treatment, sick 2.87[0.09; 91.05]22 -NAArkilo (Topiramate), 2015 1 Tags Adjustment   - No  - No 4.67[0.61; 35.75]3530%NAVajda a (Topiramate) (Controls unexposed sick) (Epilepsy), 2024 Meador (Topiramate) (Controls unexposed, sick), 2020 Arkilo (Topiramate), 2015 3   - Yes  - Yes 38.86[5.02; 301.00]1011 -NATrivedi (Topiramate) (Controls unexposed, sick), 2018 1 All studiesAll studies 13.39[3.16; 56.70]13640%NAVajda a (Topiramate) (Controls unexposed sick) (Epilepsy), 2024 Meador (Topiramate) (Controls unexposed, sick), 2020 Trivedi (Topiramate) (Controls unexposed, sick), 2018 Arkilo (Topiramate), 2015 40.5100.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-4.87.42.4740.000Vajda a (Topiramate) (Controls unexposed sick) (Epilepsy), 2024Meador (Topiramate) (Controls unexposed, sick), 2020Trivedi (Topiramate) (Controls unexposed, sick), 2018Arkilo (Topiramate), 2015

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

not enought points

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 8578, 8564, 8565, 16756

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) Out of scale19.18[0.35; 1060.61]-6 -NAMeador (Topiramate) (Controls unexposed, disease free), 2020 1 unexposed, sick controlsunexposed, sick controls Out of scale18.53[3.79; 90.73]11620%NAVajda a (Topiramate) (Controls unexposed sick) (Epilepsy), 2024 Meador (Topiramate) (Controls unexposed, sick), 2020 Trivedi (Topiramate) (Controls unexposed, sick), 2018 3 exposed to other treatment, sick controlsexposed to other treatment, sick controls 3.17[0.88; 11.41]256419%NAVajda a (Topiramate) (Controls exposed to LTG) (Epilepsy), 2024 Meador (Topiramate) (Controls exposed to Lamotrigine, sick), 2020 Trivedi (Topiramate) (Controls exposed to Lamotrigine, sick), 2018 Arkilo (Topiramate), 2015 40.510.01.0

Umbrella review (other published meta-analyses)

Published MAControlPeriodTE95% CIn exposedkI2 Veroniki a (NMA) (All indications) (Combined ...Veroniki a (NMA) (All indications) (Combined fetal losses) Out of scale23.58[1.18; 549.60]NA-Wwhatever (meta-analysis)Anyduring pregnancy (anytime or not specified)studies TTT-9 metaPregmetaPreg Out of scale13.39[3.16; 56.70]0%64----Vajda a (Topiramate) (Controls unexposed sick) (Epilepsy), 2024 Meador (Topiramate) (Controls unexposed, sick), 2020 Trivedi (Topiramate) (Controls unexposed, sick), 2018 Arkilo (Topiramate), 2015 40.510.01.0