Primidone AND Phenobarbital (Epilepsy) updated on 04-22-2025

Neuro-developmental disorders (as a whole)

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.
S8704
R29347
Coste (Phenobarbital) (Controls exposed to Lamotrigine, sick), 2020 Diagnosis Disorders of psychological development (F80–F89) (mean age of 3.6 years old) during pregnancy (anytime or not specified) retrospective cohort (claims database) exposed to other treatment, sick excluded Adjustment: No Controls: mixed indications 1.24 [0.17;9.26] C
excluded (control group)
1/84   27/2,813 28 84
ref
S8705
R29365
Coste (Phenobarbital) (Controls unexposed, NOS), 2020 Diagnosis Disorders of psychological development (F80–F89) (mean age of 3.6 years old) during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: Yes 0.90 [0.10;6.70] 1/84   10,010/1,710,441 10,011 84
ref
S8674
R29219
Dean (Phenobarbital) (Controls exposed to Lamotrigine, sick), 2007 Neurodevelopmental disorder (mean age in years: m1=16.25 and m0=1.5) during pregnancy (anytime or not specified) retrospective cohort exposed to other treatment, sick excluded Adjustment: No 1.24 [0.06;26.43] C
excluded (control group)
7/50   0/4 7 50
ref
S8675
R29221
Dean (Phenobarbital) (Controls unexposed, sick), 2007 Neurodevelopmental disorder (mean age in years: m1=16.25 and m0=15.25) during pregnancy (anytime or not specified) retrospective cohort unexposed, sick Adjustment: No 2.33 [0.57;9.62] C 7/50   3/46 10 50
ref
S8662
R29176
Katz (Phenobarbital or Primidone), 2001 Developmental delay (Based on the DSM-IV-TR criteria) during pregnancy (anytime or not specified) retrospective cohort exposed to other treatment, sick Adjustment: No 0.38 [0.01;25.21] C 0/7   0/3 0 7
ref
S8714
R29414
Van der Pol (Phenobarbital) (Controls unexposed, disease free), 1991 Nonoptimal school career throughout pregnancy prospective cohort unexposed, disease free excluded Adjustment: No Matched 2.20 [0.55;8.77] C
excluded (control group)
4/12   10/54 14 12
ref
S8715
R29439
Van der Pol (Phenobarbital) (Controls unexposed, sick), 1991 Nonoptimal school career throughout pregnancy prospective cohort unexposed, sick Adjustment: No 1.70 [0.36;8.09] C 4/12   5/22 9 12
ref
Total 4 studies 1.60 [0.64;4.00] 10,030 153
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 Coste (Phenobarbital) (Controls unexposed, NOS), 2020Coste, 2020 1 0.90[0.10; 6.70]10,0118419%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Dean (Phenobarbital) (Controls unexposed, sick), 2007Dean, 2007 2 2.33[0.57; 9.62]105042%ROB confusion: criticalROB selection: criticalROB classification: lowROB missing: criticalROB mesure: criticalROB reporting: moderate Katz (Phenobarbital or Primidone), 2001Katz, 2001 3 0.38[0.01; 25.21]075%ROB confusion: criticalROB selection: criticalROB classification: lowROB missing: lowROB mesure: moderateROB reporting: moderate Van der Pol (Phenobarbital) (Controls unexposed, sick), 1991Van der Pol, 1991 4 1.70[0.36; 8.09]91234%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Total (4 studies) I2 = 0% 1.60[0.64; 4.00]10,0301530.25.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Phenobarbital) (Controls unexposed, NOS; 2: Phenobarbital) (Controls unexposed, sick; 3: Phenobarbital or Primidone; 4: Phenobarbital) (Controls unexposed, sick;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.60[0.64; 4.00]10,0301530%NACoste (Phenobarbital) (Controls unexposed, NOS), 2020 Dean (Phenobarbital) (Controls unexposed, sick), 2007 Katz (Phenobarbital or Primidone), 2001 Van der Pol (Phenobarbital) (Controls unexposed, sick), 1991 4 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 0.90[0.11; 7.37]10,01184 -NACoste (Phenobarbital) (Controls unexposed, NOS), 2020 1 unexposed, sickunexposed, sick 2.02[0.71; 5.77]19620%NADean (Phenobarbital) (Controls unexposed, sick), 2007 Van der Pol (Phenobarbital) (Controls unexposed, sick), 1991 2 exposed to other treatment, sickexposed to other treatment, sick 0.38[0.01; 25.21]-7 -NAKatz (Phenobarbital or Primidone), 2001 1 Tags Adjustment   - No  - No 1.83[0.66; 5.07]19690%NADean (Phenobarbital) (Controls unexposed, sick), 2007 Katz (Phenobarbital or Primidone), 2001 Van der Pol (Phenobarbital) (Controls unexposed, sick), 1991 3   - Yes  - Yes 0.90[0.11; 7.37]10,01184 -NACoste (Phenobarbital) (Controls unexposed, NOS), 2020 1 All studiesAll studies 1.60[0.64; 4.00]10,0301530%NACoste (Phenobarbital) (Controls unexposed, NOS), 2020 Dean (Phenobarbital) (Controls unexposed, sick), 2007 Katz (Phenobarbital or Primidone), 2001 Van der Pol (Phenobarbital) (Controls unexposed, sick), 1991 40.15.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-5.05.52.5610.000Coste (Phenobarbital) (Controls unexposed, NOS), 2020Dean (Phenobarbital) (Controls unexposed, sick), 2007Katz (Phenobarbital or Primidone), 2001Van der Pol (Phenobarbital) (Controls unexposed, sick), 1991

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 8714, 8674, 8704

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.68[0.53; 5.33]10,025960%NACoste (Phenobarbital) (Controls unexposed, NOS), 2020 Van der Pol (Phenobarbital) (Controls unexposed, disease free), 1991 2 unexposed, sick controlsunexposed, sick controls 2.02[0.71; 5.77]19620%NADean (Phenobarbital) (Controls unexposed, sick), 2007 Van der Pol (Phenobarbital) (Controls unexposed, sick), 1991 2 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.05[0.22; 5.01]351410%NACoste (Phenobarbital) (Controls exposed to Lamotrigine, sick), 2020 Dean (Phenobarbital) (Controls exposed to Lamotrigine, sick), 2007 Katz (Phenobarbital or Primidone), 2001 30.510.01.0