Levetiracetam versus valproate for new-onset or previously treated but inadequately controlled epilepsy in children: a systematic review and meta-analysis of randomized controlled trials

To compare the efficacy and safety of levetiracetam versus valproate in children with new-onset or previously treated but inadequately controlled epilepsy.

We systematically searched PubMed, Scopus, Web of Science, and Cochrane Library from inception to April 2026 for randomized controlled trials (RCTs) comparing levetiracetam versus valproate in children (aged 0-18 years) with new-onset or previously treated but inadequately controlled epilepsy. Outcomes included seizure freedom, exploratory analyses of survival time without seizure and time to first seizure recurrence, change in aspartate aminotransferase (AST) levels, and adverse events.