Effectiveness and safety of stiripentol in epilepsy: A systematic review and meta-analysis
Bibliographic record
Abstract
This systematic review and meta-analysis aimed to evaluate the safety and efficacy of stiripentol (STP) in patients with epilepsy, including those with Dravet syndrome (DS) and status epilepticus (SE). A comprehensive search of PubMed, Scopus, and Web of Science was conducted for articles published up to February 20, 2025. Eligible studies included clinical trials, cohort studies, case series, and cross-sectional analyses assessing STP in epilepsy. Two independent reviewers screened the studies and extracted data. Outcomes included ≥50 % seizure reduction, seizure freedom, and adverse events (AEs). Risk of bias was assessed using the Newcastle–Ottawa Scale and Joanna Briggs Institute tools. Meta-analyses were performed using a random-effects model to account for study heterogeneity. Twenty-nine studies ( n = 1445) were included. Overall, 52.2 % (95 % confidence interval [CI]: 43.1–61.1 %) of patients achieved ≥50 % seizure reduction, and 12.0 % (95 % CI: 7.7–18.1 %) achieved seizure freedom. Subgroup analyses showed ≥50 % seizure reduction in SE (73.9 %, 95 % CI: 28.6–95.2 %), generalized myoclonic seizures and/or generalized atypical absence seizures (65.0 %, 95 % CI: 50.7–77.0 %), focal epilepsy (56.5 %, 95 % CI: 48.3–64.3 %), DS (47.8 %, 95 % CI: 39.8–56.0 %), and generalized tonic–clonic seizures (46.2 %, 95 % CI: 35.9–56.8 %). Seizure freedom was highest in the SE group (31.3 %, 95 % CI: 16.2–51.6 %) and lowest in the DS group (7.9 %, 95 % CI: 4.6–13.1 %). The most common AEs were drowsiness (28.2 %, 95 % CI: 18.6–37.7 %), behavioral changes (24.5 %, 95 % CI: 9.2–39.7 %), weight loss (22.6 %, 95 % CI: 14.2–31.1 %), and decreased appetite (22.0 %, 95 % CI: 14.7–29.3 %). Treatment discontinuation due to AEs occurred in 7.2 % (95 % CI: 3.6–10.8 %) of patients. STP is a well-tolerated and effective adjunctive treatment for refractory epilepsy, particularly in SE and DS. It significantly reduces seizure frequency, with a meaningful rate of seizure freedom in SE. Most AEs were mild, supporting the clinical value of STP in patients with difficult-to-treat epilepsy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.026 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.021 | 0.050 |
| Bibliometrics | 0.007 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".