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

Limb defects

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.
S17500
R73538		 Wiggs (Epilepsy) (Levetiracetam), 2024 Musculoskeletal system malformations early pregnancy population based cohort retrospective unexposed, sick Adjustment: Yes 1.91 [0.58;6.29] -/185   -/9,364 - 185
ref
S12825
R48281		 Thomas (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2021 Skeletal malformations 1st trimester prospective cohort exposed to other treatment, sick excluded Adjustment: No 2.39 [0.11;50.76] C
excluded (control group) 		2/106   0/50 2 106
ref
S12827
R48293		 Thomas (Levetiracetam) (Controls unexposed, sick), 2021 Skeletal malformations 1st trimester prospective cohort unexposed, sick Adjustment: No 3.25 [0.45;23.36] C 2/106   2/340 4 106
ref
S9002
R30581		 Morrow (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2006 Skeletal abnormalities 1st trimester prospective cohort exposed to other treatment, sick Adjustment: No 6.00 [0.28;128.72] C 0/22   2/647 2 22
ref
Total 3 studies 2.43 [0.92;6.40] 6 313
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 Wiggs (Epilepsy) (Levetiracetam), 2024Wiggs, 2024 1 1.91[0.58; 6.29]-18566%ROB confusion: seriousROB selection: moderateROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Thomas (Levetiracetam) (Controls unexposed, sick), 2021Thomas, 2021 2 3.25[0.45; 23.36]410624%ROB confusion: seriousROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Morrow (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2006Morrow, 2006 3 6.00[0.28; 128.72]22210%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Total (3 studies) I2 = 0% 2.43[0.92; 6.40]63130.520.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

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

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 2.43[0.92; 6.40]63130%NAWiggs (Epilepsy) (Levetiracetam), 2024 Thomas (Levetiracetam) (Controls unexposed, sick), 2021 Morrow (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2006 3 case control studiescase control studies 0 Type of controls unexposed, sickunexposed, sick 2.20[0.79; 6.11]42910%NAWiggs (Epilepsy) (Levetiracetam), 2024 Thomas (Levetiracetam) (Controls unexposed, sick), 2021 2 exposed to other treatment, sickexposed to other treatment, sick 6.00[0.28; 128.72]222 -NAMorrow (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2006 1 Tags Adjustment   - No  - No 3.89[0.74; 20.42]61280%NAThomas (Levetiracetam) (Controls unexposed, sick), 2021 Morrow (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2006 2   - Yes  - Yes 1.91[0.58; 6.29]-185 -NAWiggs (Epilepsy) (Levetiracetam), 2024 1 All studiesAll studies 2.43[0.92; 6.40]63130%NAWiggs (Epilepsy) (Levetiracetam), 2024 Thomas (Levetiracetam) (Controls unexposed, sick), 2021 Morrow (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2006 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 12825

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed, sick controlsunexposed, sick controls 2.20[0.79; 6.11]42910%NAWiggs (Epilepsy) (Levetiracetam), 2024 Thomas (Levetiracetam) (Controls unexposed, sick), 2021 2 exposed to other treatment, sick controlsexposed to other treatment, sick controls 3.78[0.43; 32.92]41280%NAThomas (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2021 Morrow (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2006 20.510.01.0

Umbrella review (other published meta-analyses)

Published MAControlPeriodTE95% CIn exposedkI2 Bromley (Levetiracetam) (All indications) (Sk ...Bromley (Levetiracetam) (All indications) (Skeletal / Limb Malformations (Cohort studies)) 1.36[0.45; 4.13]0%-Eexposed to other treatment, sickAnyduring pregnancy (anytime or not specified)studies TTT9 Bromley (Levetiracetam) (All indications) (Sk ...Bromley (Levetiracetam) (All indications) (Skeletal / Limb Malformations (Cohort studies)) 3.21[0.46; 22.50]NA-U,Sunexposed, sickAnyduring pregnancy (anytime or not specified)studies TTT1 metaPregmetaPreg 2.43[0.92; 6.40]0%313----Wiggs (Epilepsy) (Levetiracetam), 2024 Thomas (Levetiracetam) (Controls unexposed, sick), 2021 Morrow (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2006 30.510.01.0