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

Nervous system anomalies

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.
S17486
R73494		 Wiggs (Epilepsy) (Carbamazepine), 2024 Nervous system malformations early pregnancy population based cohort retrospective unexposed, sick Adjustment: Yes 0.91 [0.29;2.81] -/1,456   -/12,666 - 1,456
ref
S15198
R62335		 Cohen (Carbamazepine) (Mixed indications) (Controls unexposed, NOS), 2023 Nervous system malformation 1st trimester population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes 0.70 [0.26;1.87] -/2,674   -/4,866,362 - 2,674
ref
S12856
R48495		 Thomas (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2021 Neural malformations 1st trimester prospective cohort exposed to other treatment, sick excluded Adjustment: No 1.33 [0.07;23.98] C
excluded (control group) 		6/490   0/50 6 490
ref
S12858
R48507		 Thomas (Carbamazepine) (Controls unexposed, sick), 2021 Neural malformations 1st trimester prospective cohort unexposed, sick Adjustment: No 9.13 [0.51;162.59] C 6/490   0/340 6 490
ref
S9763
R34867		 Ban (Carbamazepine) (Mixed indications) (Controls exposed to Lamotrigine, sick), 2015 Nervous system anomaly 1st trimester prospective cohort exposed to other treatment, sick excluded Adjustment: No 2.39 [0.10;59.00] C
excluded (control group) 		1/343   0/273 1 343
ref
S9764
R34873		 Ban (Carbamazepine) (Mixed indications) (Controls unexposed NOS), 2015 Nervous system anomaly 1st trimester prospective cohort unexposed (general population or NOS) Adjustment: No 2.05 [0.29;14.60] C 1/343   367/257,153 368 343
ref
S9643
R34315		 Veiby (Carbamazepine) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2014 Nervous system throughout pregnancy population based cohort retrospective exposed to other treatment, sick Adjustment: No 0.40 [0.02;9.96] C 0/685   1/833 1 685
ref
Total 5 studies 0.97 [0.50;1.88] 375 5,648
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) (Carbamazepine), 2024Wiggs, 2024 1 0.91[0.29; 2.81]-1,45634%ROB confusion: seriousROB selection: moderateROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Cohen (Carbamazepine) (Mixed indications) (Controls unexposed, NOS), 2023Cohen, 2023 2 0.70[0.26; 1.87]-2,67445%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Thomas (Carbamazepine) (Controls unexposed, sick), 2021Thomas, 2021 3 9.13[0.51; 162.59]64905%ROB confusion: seriousROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Ban (Carbamazepine) (Mixed indications) (Controls unexposed NOS), 2015Ban, 2015 4 2.05[0.29; 14.60]36834311%ROB confusion: criticalROB selection: moderateROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Veiby (Carbamazepine) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2014Veiby, 2014 5 0.40[0.02; 9.96]16854%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: moderateROB mesure: moderateROB reporting: moderate Total (5 studies) I2 = 0% 0.97[0.50; 1.88]3755,6480.220.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Epilepsy) (Carbamazepine; 2: Carbamazepine) (Mixed indications) (Controls unexposed, NOS; 3: Carbamazepine) (Controls unexposed, sick; 4: Carbamazepine) (Mixed indications) (Controls unexposed NOS; 5: Carbamazepine) (Controls exposed to Lamotrigine, sick) (Mixed indications;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 0.97[0.50; 1.88]3755,6480%NAWiggs (Epilepsy) (Carbamazepine), 2024 Cohen (Carbamazepine) (Mixed indications) (Controls unexposed, NOS), 2023 Thomas (Carbamazepine) (Controls unexposed, sick), 2021 Ban (Carbamazepine) (Mixed indications) (Controls unexposed NOS), 2015 Veiby (Carbamazepine) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2014 5 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 0.87[0.36; 2.10]3683,0170%NACohen (Carbamazepine) (Mixed indications) (Controls unexposed, NOS), 2023 Ban (Carbamazepine) (Mixed indications) (Controls unexposed NOS), 2015 2 unexposed, sickunexposed, sick 1.94[0.23; 16.21]61,94653%NAWiggs (Epilepsy) (Carbamazepine), 2024 Thomas (Carbamazepine) (Controls unexposed, sick), 2021 2 exposed to other treatment, sickexposed to other treatment, sick 0.40[0.02; 9.96]1685 -NAVeiby (Carbamazepine) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2014 1 Tags Adjustment   - No  - No 2.14[0.50; 9.19]3751,5181%NAThomas (Carbamazepine) (Controls unexposed, sick), 2021 Ban (Carbamazepine) (Mixed indications) (Controls unexposed NOS), 2015 Veiby (Carbamazepine) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2014 3   - Yes  - Yes 0.78[0.37; 1.65]-4,1300%NAWiggs (Epilepsy) (Carbamazepine), 2024 Cohen (Carbamazepine) (Mixed indications) (Controls unexposed, NOS), 2023 2 All studiesAll studies 0.97[0.50; 1.88]3755,6480%NAWiggs (Epilepsy) (Carbamazepine), 2024 Cohen (Carbamazepine) (Mixed indications) (Controls unexposed, NOS), 2023 Thomas (Carbamazepine) (Controls unexposed, sick), 2021 Ban (Carbamazepine) (Mixed indications) (Controls unexposed NOS), 2015 Veiby (Carbamazepine) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2014 50.220.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-3.83.81.9610.000Wiggs (Epilepsy) (Carbamazepine), 2024Cohen (Carbamazepine) (Mixed indications) (Controls unexposed, NOS), 2023Thomas (Carbamazepine) (Controls unexposed, sick), 2021Ban (Carbamazepine) (Mixed indications) (Controls unexposed NOS), 2015Veiby (Carbamazepine) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2014

Asymetry test p-value = 0.3300 (by Egger's regression)

slope=-0.8019 (0.7305); intercept=1.1215 (0.9669); t=1.1599; p=0.3300

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 9763, 12856

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 0.87[0.36; 2.10]3683,0170%NACohen (Carbamazepine) (Mixed indications) (Controls unexposed, NOS), 2023 Ban (Carbamazepine) (Mixed indications) (Controls unexposed NOS), 2015 2 unexposed, sick controlsunexposed, sick controls 1.94[0.23; 16.21]61,94653%NAWiggs (Epilepsy) (Carbamazepine), 2024 Thomas (Carbamazepine) (Controls unexposed, sick), 2021 2 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.10[0.19; 6.57]81,5180%NAThomas (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2021 Ban (Carbamazepine) (Mixed indications) (Controls exposed to Lamotrigine, sick), 2015 Veiby (Carbamazepine) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2014 30.510.01.0