Comparison of Oxcarbazepine and Carbamazepine in the treatment of Trigeminal Neuralgia: a systematic review and meta-analysis

Comparison of Oxcarbazepine and Carbamazepine in the treatment of Trigeminal Neuralgia: a systematic review and meta-analysis | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Comparison of Oxcarbazepine and Carbamazepine in the treatment of Trigeminal Neuralgia: a systematic review and meta-analysis Cristian Mendieta, Marina Barbosa Da Silva, Livia Aguiar Nogueira-Rosa, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4864620/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 10 You are reading this latest preprint version Abstract Oxcarbazepine (OXC) has demonstrated comparable efficacy to Carbamazepine (CBZ) in the treatment of Trigeminal neuralgia (TN), with the added benefit of fewer adverse events (AEs). Whether it can be used as a substitute for carbamazepine is yet to be verified. To address this, we conducted a comprehensive meta-analysis, exploring efficacy and adverse events in detail. We searched PubMed, Embase, Cochrane Library, and Google Scholar for studies comparing CBZ to OXC in patients with TN. The main outcomes were efficacy, AEs, frequency of neurological AEs, skin reactions, and alterations in laboratory parameters. Statistical analysis was performed using Review Manager 5.4.1. And the risk of bias was assessed using RoB-2 and ROBINS-I. We included 838 patients from three observational studies and two randomized clinical trials (RCTs). CBZ was used to treat TN in 445 (53.1%) patients. The CBZ group when compared with the OXC group had no significant difference in efficacy (OR:0.58; 95% Cl:0.14-2.40; p=0.45). Both groups had significant differences noted in AEs, with higher frequency observed in the CBZ group (OR:2.30; 95% Cl:1.49-3.54; p=0.0002). Similarly, there was a significant difference in neurological AEs (OR:2.76; 95% Cl:1.53-4.87; p=0.0007). OXC and CBZ demonstrated similar efficacy in treating trigeminal neuralgia. However, the consideration of adverse events may favor clinical decision-making to OXC due to its superiority. Nonetheless, more randomized controlled trials (RCTs) are necessary to confirm this conclusion in the future Trigeminal neuralgia Carbamazepine Oxcarbazepine Efficacy Adverse Events Side Effect Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 30 Sep, 2024 Reviews received at journal 27 Sep, 2024 Reviewers agreed at journal 20 Sep, 2024 Reviews received at journal 16 Sep, 2024 Reviewers agreed at journal 16 Sep, 2024 Reviewers invited by journal 13 Sep, 2024 Editor assigned by journal 09 Sep, 2024 Editor invited by journal 31 Aug, 2024 Submission checks completed at journal 29 Aug, 2024 First submitted to journal 05 Aug, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4864620","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":356860255,"identity":"f7162429-4f3b-412a-b2ae-5ccd862fd68f","order_by":0,"name":"Cristian Mendieta","email":"data:image/png;base64,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","orcid":"","institution":"University of Saint Francis Xavier","correspondingAuthor":true,"prefix":"","firstName":"Cristian","middleName":"","lastName":"Mendieta","suffix":""},{"id":356860257,"identity":"893dff7d-b14b-42ad-837a-db4a73d48e54","order_by":1,"name":"Marina Barbosa Da Silva","email":"","orcid":"","institution":"Federal University of the State of Rio de Janeiro","correspondingAuthor":false,"prefix":"","firstName":"Marina","middleName":"Barbosa Da","lastName":"Silva","suffix":""},{"id":356860258,"identity":"0856cf93-91d7-4f12-a317-411685ca6cc6","order_by":2,"name":"Livia Aguiar Nogueira-Rosa","email":"","orcid":"","institution":"Centro Universitário Barão de Mauá","correspondingAuthor":false,"prefix":"","firstName":"Livia","middleName":"Aguiar","lastName":"Nogueira-Rosa","suffix":""},{"id":356860260,"identity":"d8ef5ac2-a632-4beb-9bae-e04722a6f061","order_by":3,"name":"Domênica Baroni Coelho de Oliveira Ferreira","email":"","orcid":"","institution":"Rio de Janeiro State University","correspondingAuthor":false,"prefix":"","firstName":"Domênica","middleName":"Baroni Coelho de Oliveira","lastName":"Ferreira","suffix":""},{"id":356860261,"identity":"0471731c-dfa7-41be-b89c-975039afddb0","order_by":4,"name":"Jhon Bocanegra-Becerra","email":"","orcid":"","institution":"Cayetano Heredia University","correspondingAuthor":false,"prefix":"","firstName":"Jhon","middleName":"","lastName":"Bocanegra-Becerra","suffix":""},{"id":356860263,"identity":"83b5cffd-9229-43ed-97c3-7d890c78731a","order_by":5,"name":"Nathalia Moraes Figueiredo","email":"","orcid":"","institution":"University of Rochester Medical Center","correspondingAuthor":false,"prefix":"","firstName":"Nathalia","middleName":"Moraes","lastName":"Figueiredo","suffix":""}],"badges":[],"createdAt":"2024-08-06 00:40:37","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4864620/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4864620/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":65462928,"identity":"ce378e14-e533-4dc9-98dc-88f8201fd124","added_by":"auto","created_at":"2024-09-27 18:25:37","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1139781,"visible":true,"origin":"","legend":"","description":"","filename":"ManuscriptCBZvsOXCd1.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4864620/v1_covered_fa003b9b-5204-4b83-9ca5-c2ef759db7c5.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Comparison of Oxcarbazepine and Carbamazepine in the treatment of Trigeminal Neuralgia: a systematic review and meta-analysis","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Trigeminal neuralgia, Carbamazepine, Oxcarbazepine, Efficacy, Adverse Events, Side Effect","lastPublishedDoi":"10.21203/rs.3.rs-4864620/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4864620/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"Oxcarbazepine (OXC) has demonstrated comparable efficacy to Carbamazepine (CBZ) in the treatment of Trigeminal neuralgia (TN), with the added benefit of fewer adverse events (AEs). Whether it can be used as a substitute for carbamazepine is yet to be verified. To address this, we conducted a comprehensive meta-analysis, exploring efficacy and adverse events in detail. We searched PubMed, Embase, Cochrane Library, and Google Scholar for studies comparing CBZ to OXC in patients with TN. The main outcomes were efficacy, AEs, frequency of neurological AEs, skin reactions, and alterations in laboratory parameters. Statistical analysis was performed using Review Manager 5.4.1. And the risk of bias was assessed using RoB-2 and ROBINS-I. We included 838 patients from three observational studies and two randomized clinical trials (RCTs). CBZ was used to treat TN in 445 (53.1%) patients. The CBZ group when compared with the OXC group had no significant difference in efficacy (OR:0.58; 95% Cl:0.14-2.40; p=0.45). Both groups had significant differences noted in AEs, with higher frequency observed in the CBZ group (OR:2.30; 95% Cl:1.49-3.54; p=0.0002). Similarly, there was a significant difference in neurological AEs (OR:2.76; 95% Cl:1.53-4.87; p=0.0007). OXC and CBZ demonstrated similar efficacy in treating trigeminal neuralgia. However, the consideration of adverse events may favor clinical decision-making to OXC due to its superiority. Nonetheless, more randomized controlled trials (RCTs) are necessary to confirm this conclusion in the future","manuscriptTitle":"Comparison of Oxcarbazepine and Carbamazepine in the treatment of Trigeminal Neuralgia: a systematic review and meta-analysis","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-09-27 18:17:30","doi":"10.21203/rs.3.rs-4864620/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-09-30T04:48:37+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-09-27T16:51:50+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"335698515813309087315583015534386414681","date":"2024-09-20T13:17:49+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-09-16T20:40:30+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"110691023285788084122029670925314319087","date":"2024-09-16T17:12:13+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-09-14T01:44:51+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-09-09T06:20:16+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2024-08-31T11:16:29+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-08-29T07:09:05+00:00","index":"","fulltext":""},{"type":"submitted","content":"Scientific Reports","date":"2024-08-06T00:38:59+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"95158e2c-5769-4009-9fea-a659b5bcb0fe","owner":[],"postedDate":"September 27th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2024-11-19T10:53:40+00:00","versionOfRecord":[],"versionCreatedAt":"2024-09-27 18:17:30","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4864620","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4864620","identity":"rs-4864620","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}