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Meta-Analysis
. 2017 Feb 15;17(1):32.
doi: 10.1186/s12883-017-0801-x.

Relationship between ABCB1 3435TT genotype and antiepileptic drugs resistance in Epilepsy: updated systematic review and meta-analysis

Malek Chouchi  1   2 , Wajih Kaabachi  3 , Hedia Klaa  4 , Kalthoum Tizaoui  3 , Ilhem Ben-Youssef Turki  4 , Lamia Hila  5
Affiliations
Meta-Analysis

Relationship between ABCB1 3435TT genotype and antiepileptic drugs resistance in Epilepsy: updated systematic review and meta-analysis

Malek Chouchi et al. BMC Neurol. .

Abstract

Background: Antiepileptic drugs (AEDs) are effective medications available for epilepsy. However, many patients do not respond to this treatment and become resistant. Genetic polymorphisms may be involved in the variation of AEDs response. Therefore, we conducted an updated systematic review and a meta-analysis to investigate the contribution of the genetic profile on epilepsy drug resistance.

Methods: We proceeded to the selection of eligible studies related to the associations of polymorphisms with resistance to AEDs therapy in epilepsy, published from January 1980 until November 2016, using Pubmed and Cochrane Library databases. The association analysis was based on pooled odds ratios (ORs) and 95% confidence intervals (CIs).

Results: From 640 articles, we retained 13 articles to evaluate the relationship between ATP-binding cassette sub-family C member 1 (ABCB1) C3435T polymorphism and AEDs responsiveness in a total of 454 epileptic AEDs-resistant cases and 282 AEDs-responsive cases. We found a significant association with an OR of 1.877, 95% CI 1.213-2.905. Subanalysis by genotype model showed a more significant association between the recessive model of ABCB1 C3435T polymorphism (TT vs. CC) and the risk of AEDs resistance with an OR of 2.375, 95% CI 1.775-3.178 than in the dominant one (CC vs. TT) with an OR of 1.686, 95% CI 0.877-3.242.

Conclusion: Our results indicate that ABCB1 C3435T polymorphism, especially TT genotype, plays an important role in refractory epilepsy. As genetic screening of this genotype may be useful to predict AEDs response before starting the treatment, further investigations should validate the association.

Keywords: ABCB1 C3435T polymorphism; Antiepileptic drugs; Epilepsy; Meta-analysis; Resistance.

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Figures

Fig. 1
Fig. 1
PRISMA flow diagram: study methodology of excluded and included articles
Fig. 2
Fig. 2
Association between ABCB1 C3435T polymorphism and AEDs resistant epilepsy. Forest plot showed individual and overall ORs (black squares) with corresponding 95% CIs (horizontal bars) by individual report. P-value showed statistical significance of ORs and Z-value showed uniformisation of values and its position in the full distribution of values. Heterogeneity between the studies was mentioned
Fig. 3
Fig. 3
Association between ABCB1 3435CC genotype and AEDs resistant epilepsy. Forest plot showed individual and overall ORs (black squares) with corresponding 95% CIs (horizontal bars) by individual report. P-value showed statistical significance of ORs and Z-value showed uniformisation of values and its position in the full distribution of values. Heterogeneity between the studies was mentioned
Fig. 4
Fig. 4
Association between ABCB1 3435TT genotype and AEDs resistant epilepsy. Forest plot showed individual and overall ORs (black squares) with corresponding 95% CIs (horizontal bars) by individual report. P-value showed statistical significance of ORs and Z-value showed uniformisation of values and its position in the full distribution of values. Heterogeneity between the studies was mentioned
Fig. 5
Fig. 5
Publication bias of the association between ABCB1 C3435T polymorphism and AEDs resistant epilepsy
Fig. 6
Fig. 6
Publication bias of the association between ABCB1 3435CC genotype model and AEDs resistant epilepsy
Fig. 7
Fig. 7
Publication bias of the association between ABCB1 3435TT genotype model and AEDs resistant epilepsy
See this image and copyright information in PMC

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