Effectiveness of Topiramate Versus Acetazolamide in the Management of Idiopathic Intracranial Hypertension: ASystematic Review and Meta-Analysis.

IF 2.4 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Abdullah Almaqhawi, Alia Alokley, Reham Alamri, Razan Alabdulqader, Ahmad Alali, Ayat Aleid, Amani Alhejji, Maryam N ALNasser
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Abstract

Background and Objectives: Primary pseudotumor cerebri syndrome, another name for idiopathic intracranial hypertension (IIH), is a neurological condition marked by elevated intracranial pressure (ICP) that can result in papilledema without a known etiology. The purpose of this study is to compare the efficacy of topiramate and acetazolamide as medical treatments for IIH and to evaluate the long-term outcomes of both medications. Materials and Methods: This systematic review and meta-analysis followed the PRISMA guidelines and was approved by the International Prospective Register for Systematic Reviews (PROSPERO). This study included randomized clinical trials, retrospective and prospective cohort studies, and patients with idiopathic intracranial hypertension (IIH). Data extraction was performed using the Rayyan application, and the risk of bias was assessed using the Critical Appraisal Skills Program (CASP). Results: The findings revealed a statistically significant 67% increase in the likelihood of improvement at 6 months compared to the baseline with the administration of acetazolamide and topiramate. After six months of the drug administration, there was a 3.6 times decrease in visual obscuration compared to the baseline. A significant advantage of topiramate in IIH is the added benefit of weight loss, since obesity is a modifiable risk factor. However, acetazolamide remains the conventional treatment. Conclusions: This study found that acetazolamide and topiramate are both effective therapies for idiopathic intracranial hypertension (IIH), improving visual metrics and decreasing cerebrospinal fluid pressure. Topiramate aids in weight reduction, while acetazolamide is recommended for its ability to lower CSF pressure and alleviate visual changes. A combination treatment of topiramate and acetazolamide is recommended for better results.

托吡酯与乙酰唑胺治疗特发性颅内高压的有效性:系统回顾和荟萃分析。
背景和目的:原发性假性脑瘤综合征,特发性颅内高压(IIH)的另一个名称,是一种以颅内压(ICP)升高为特征的神经系统疾病,可导致乳头水肿,病因不明。本研究的目的是比较托吡酯和乙酰唑胺作为IIH药物治疗的疗效,并评估两种药物的长期疗效。材料和方法:本系统评价和荟萃分析遵循PRISMA指南,并获得国际前瞻性系统评价注册(PROSPERO)的批准。本研究包括随机临床试验、回顾性和前瞻性队列研究以及特发性颅内高压(IIH)患者。使用Rayyan应用程序进行数据提取,并使用关键评估技能程序(CASP)评估偏倚风险。结果:研究结果显示,与基线相比,乙酰唑胺和托吡酯在6个月时改善的可能性增加了67%。服药六个月后,与基线相比,视力遮挡下降了3.6倍。托吡酯治疗IIH的一个显著优势是体重减轻,因为肥胖是一个可改变的危险因素。然而,乙酰唑胺仍然是传统的治疗方法。结论:本研究发现乙酰唑胺和托吡酯均是治疗特发性颅内高压(IIH)的有效药物,可改善视觉指标并降低脑脊液压。托吡酯有助于减轻体重,而乙酰唑胺因其降低脑脊液压力和减轻视力变化的能力而被推荐。托吡酯和乙酰唑胺联合治疗效果更好。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Medicina-Lithuania
Medicina-Lithuania 医学-医学:内科
CiteScore
3.30
自引率
3.80%
发文量
1578
审稿时长
25.04 days
期刊介绍: The journal’s main focus is on reviews as well as clinical and experimental investigations. The journal aims to advance knowledge related to problems in medicine in developing countries as well as developed economies, to disseminate research on global health, and to promote and foster prevention and treatment of diseases worldwide. MEDICINA publications cater to clinicians, diagnosticians and researchers, and serve as a forum to discuss the current status of health-related matters and their impact on a global and local scale.
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