The RVC’s canine epilepsy clinic has carried out the first ever systematic review and meta-analysis on the tolerability and safety of all AEDs in canine epilepsy, concluding that the effectiveness of testing anti-epileptic drugs’ (AEDs) safety and tolerability for canine epilepsy has been below the expected standard.

The aim of the study was to assess the adverse effect profile of each individual AED by analysing all available data that has been published for each specific AED and then evaluating how reliable the data was. The study was published in BMC Veterinary Research (DOI: 10.1186/s12917-016-0703-y).

To do this the researchers gathered, screened and assessed all the information published in peer-reviewed journals and publications. The individual studies were then evaluated based on the quality of evidence, study design, study group sizes, subject enrolment quality and overall risk of bias. The results, say researchers, now provide a new and more objective insight into the tolerability and safety of the AEDs.

Co-author of the study, Marios Charalambous, said: "We recruited systematic and statistical methods to combine, compare and summarize the results of independent studies and, therefore, create more objective and reliable conclusions based on the current evidence. It was a time-consuming, demanding and challenging process, but we are sure that we provide the clinicians now with essential information which they can use for daily practice."

By reviewing, assessing and untangling the vast amounts of data, the researchers found that much of the evidence for the medical treatment of canine epilepsy was based on subpar reporting of adverse effect and in studies that were below the expected standard. They say that only in recent years can the quality of studies carried out be considered adequate.

Professor Holger Volk, Clinical Director of the RVC Small Animal Referral Hospital and Professor of Veterinary Neurology and Neurosurgery (pictured right), said: "Not only does this study offer a new perspective on the management of canine epilepsy, but also highlights the importance of the need for trials which provide high quality evidence in order to have more reliable and objective results about the safety and tolerability of the AEDs in veterinary medicine."

Dr. Dave Brodbelt, Senior Lecturer in Companion Animal Epidemiology, added: “This is a valuable addition to the body of literature on canine epilepsy, highlighting safety issues and adverse events related to its management and adding further depth to the evidence base relevant to practicing vets."

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