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All Journal e-CliniC JURNAL BIOMEDIK KESMAS Universa Medicina Jurnal Kedokteran Klinik Jurnal Sinaps Medical Scope Journal (MSJ) Eduvest - Journal of Universal Studies Jurnal Kedokteran Meditek Malahayati International Journal of Nursing and Health Science Indonesian Journal of Public Health and Community Medicine
Warouw, Finny
Fakultas Kesehatan Masyarakat Universitas Sam Ratulangi Manado
Aerospace Engineering Biochemistry, Genetics & Molecular Biology Computer Science & IT Dentistry Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences

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Journal : Universa Medicina

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Effectiveness of medium-chain triglyceride diet and low glycemic index therapy in drug-resistant childhood epilepsy: a systematic review, meta-analysis, and meta-regression Wiradarma, Elbert; Khosama, Herlyani; Warouw, Finny; Wariki, Windy M. V.; Jehosua, Seilly Yunita; Pertiwi, Junita Maja
Universa Medicina Vol. 44 No. 2 (2025)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2025.v44.245-256

Abstract

Background Drug-resistant epilepsy (DRE) challenges clinical management, with many patients failing to find relief. Medium-chain triglyceride diet (MCTD) and low glycemic index therapy (LGIT) are emerging variants of the ketogenic diet. MCTD and LGIT show promise but lack clear efficacy data. The purpose of this systematic review was to evaluate and compare the efficacy of MCTD and LGIT in the management of pediatric patients with DRE. Methods Four databases were searched (PubMed, Embase, Scopus, and Cochrane Library) from November 2024 to February 2025. Two independent reviewers meticulously screened titles, abstracts, and full texts, ensuring adherence to predefined criteria.  Data extraction encompassed study characteristics, participant demographics, intervention details, and outcomes, including seizure frequency, percentage reduction, and adverse events. Statistical analyses were performed using R 4.2.2 software, assessing heterogeneity with Cochrane Q and I² and utilizing random-effects and common-effects models. Results From 1489 articles found, 487 duplicates were removed, 897 were excluded based on title and abstract screening, and of the 47 full-text articles assessed for eligibility, 31 articles were excluded, resulting in 16 articles (9 MCTD and 7 LGIT) included in this review. The pooled estimates for the proportion of children achieving seizure freedom, ≥90% seizure reduction, and ≥50% seizure reduction following the intervention were comparable between the MCTD and LGIT groups. Based on the random-effects model, the overall success proportion of MCTD in reducing seizure frequency was 0.20 [95 % Confidence Interval (CI), 0.14-0.27] (p<0.01). Meanwhile, in the LGIT group, the overall success proportion was 0.27 [95% CI,0.14- 0.45] (p<0.01). Conclusion Both MCTD and LGIT demonstrate comparable efficacy, and no definitive conclusion can be drawn regarding the superiority of one diet over the other.
Co-Authors Akili, Rahayu H, Andika Surya Atmadja Anes, Brenda Militsia Christi Rosalina Angelina Stevany Regina Masengi Anthonius Kurniadi Assa, Winly Yuliana Birang, Meirani F. Budi Ratag, Budi Budi Setiawan Chesya P.R. Salindeho Christoffel M. Memah Daniel Febrian Sengkey Deeng, Gracia V. Y. Desy . Doda, Diana V.D. Edward Nangoy, Edward Frans Wantania Gampu, Agrisia Garusu, Ratna Santika Harvani Boky, Harvani Herlyani Khosama Hugo Dwiputra Jehosua, Seilly Yunita Jimmy Posangi Jootje M.L Umboh Junita Maja P.S Junita Maja Pertiwi Kamae, Sitti Ramlia Kawatu, Paul A.T Kumayas, Putri Elshadai Labagow, Elisa Lantang, Christina Lapian, Albertus Theo Laura Wulandary Kaeng Lengkong, Erlika Lihu, Tutin R. M.L, Jootje Maddusa, Sri Seprianto Maja Pertiwi, Junita Mamahit, Juliet Merry Eva Mambo, Christi Diana Manabung, Apriliani R. Maranatha, Armando Vengo Subito Lewi Marthen Theogives Lasut, Marthen Theogives Melke J. Tumboimbela Mieke A. H. N. Kembuan Mieke A.H.N Kembuan Momole, Ansye Grace Nancy Mutiara Toreh Nike Gledis Monintja Oddi R Pinontoan Odi Pinontoan Odi Roni Pinontoan Paendong, Winner Hiskia George Paul A.T. Kawatu Pertiwi, Junita M. Pertiwi, Junita Maja Purbawijaya, Poek Denny Rahayu H. Akili, Rahayu H. Ratumbanua, Fralen Julio Rianna J Sumampouw Ricky C. Sondakh Rizal Tumewah Sekplin A. S. Sekeon, Sekplin A. S. Sengkey, Aprilia Sengkey, Omega Prisilia Soeratinoyo, Dewi K. Sugiarto, Natanael E. Sumigar, Cindy Keren Suoth, Lery F. Tangkudung, Gilbert Tewuh, Syeri Oktaviani Theresia Runtuwene Togelang, Mega Rossita Umboh, Jootje Marthen Luther Umboh, Jotje M.L Vriska V. Rambing Walewangko, Sarah Alni Wariki, Windy M. V. Wello, Novita L. L. Wiradarma, Elbert Woodford B. S. Joseph Woodford B.S. Joseph, Woodford B.S. Wowor, Ribka Yantu, Sintia Salmawati Yonathan Andrian Yulianty Sanggelorang