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Journal : Universa Medicina

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 Aaltje E Manampiring Aaltje E Manampiring Aaltje E. Manampiring Aaltje E. Manampiring Aaltje E. Manampiring Abram Babakal Abram Babakal Adam, Avelia Gustia Anastasya Adrian Jonathan Angir Adrian Umboh Ai Hori Alan Hopni Sasube Ari Astram B H. R. Kairupan Billy Karundeng Bogar, Bryan D. Bolang, Alexander Budi Setiawan Christof Toreh Daichi Suzuki Dalema, Anggreani Sintia Dewi Indra Purwanti Dhanny E. P. Lagarense Diana V. D. Doda Dina Rombot Dina Victoria Rombot Djony E. Tjandra Doda, Diana V.D. Eko Arianto Erika Ota Fidya Lestari Putri Abubakar Fitriya Adam Frelly Kuhon Frelly V. Kuhon Frendy Wihono Goni, Angelina Grace D. Kandou Grace Korompis Gustaaf A. E. Ratag Gustaaf Ratag Harsali F. Lampus Harsali Fransiscus Lampus Henry M. F. Palandeng Herlyani Khosama Hessyani Raranta Idris Sudin Iftitah M. P. Sonda Ishak Halim Octawijaya Ishak Halim Octawijaya Jeannette I. Ch. Manoppo Jehosua S. V. Sinolungan Jehosua, Seilly Yunita Jimmy Posangi Jimmy Posangi John Johannes Ezechiel Wantania Jonesius Eden Manopo Karel Pandelaki Kevin Marvil Sumanti Kondoj, Srikandy Inri Korompis, Grace Esther Caroline Lamandasa, Ghervin Imanuel Olanis Lotulung, Cindy Celine Lucyana Leonita Pongoh Manampiring, Aaltje E Manoppo, Firginia M Manoppo, Jeannete I Ch Masao Ichikawa Mercy Taroreh Moh Yudawan Prasetya Momole, Ansye Grace Nancy Mukhran Mokodompit Nathaniel Pali Nelwan, Ester Jeini Ngantung, Denny Nico Lumintang Nova Hellen Kapantow Novie H. Rampengan Novita Tombokan Paskah Thalia Lengkong Pasla, Gersom Figo Chrystianto Paulus Oroh Pertiwi, Junita Maja Porajow, Zwingly C. J. G. Porajow, Zwingly Christian Jefferson Gerard Repi, Noviano B. Rianna J Sumampouw Richard Sumangkut Rizal Tumewah Ronald I. Ottay Ruitan, Lidia S. Sapulete, Margareth Rosalinda Siagian, Iyone Esra Tiurma Sigit Wicaksono Silaban, Natalina Simangunsong, Natasya Glory Meicharisty Siwi, Imelda Maria Stivan Manopo Supit, Injilia Chintami Surotinoyo, Celline Vanessa Laurina Suryadi Nicolaas Napoleon Tatura Tandililing, Sherly Tangkudung, Yesika Merzy Indah Tommy Suharso Torondek, Julia Tumboimbela, Melke Vemy Tamaledu Veronika Maria Barbara Aryesam Warouw, Finny William William Wiradarma, Elbert Wulan P. J. Kaunang Wulan Pingkan Julia Kaunang Wullur, Raetasya Rachelea Rinda Wurangian, Prisilia Karina Yati Suriani Wangean Yuansun Khosama Zeinevaltines Tampian Zwingly Christian Porajow