Efficacy and acceptability of three prolactin-sparing antipsychotics in patient with schizophrenia: a network meta-analysis

IF 0.5 4区医学 Q4 PHARMACOLOGY & PHARMACY Psychiatry and Clinical Psychopharmacology Pub Date : 2019-09-27 DOI:10.1080/24750573.2019.1662629

Jianjie Huang, Min Chen, Ce Chen, Xiaodong Lin, Deguo Jiang, Yonghui Zhang, Lina Wang, C. Zhuo, H. Tian, C. Du

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引用次数: 2

Abstract

ABSTRACT Background: The present study aimed to systematically evaluate three prolactin-sparing antipsychotics for treating schizophrenia. Methods: We performed a meta-analysis of three prolactin-sparing antipsychotics in patients with schizophrenia. Endpoints of interest were the Positive and Negative Syndrome Scale (PANSS), Brief Psychiatric Rating Scale (BPRS), Clinical Global Impressions-Severity (CGI-S) and acceptability (all cause discontinuation). Results: A total of 12 trials (2,723 patients) and three drugs (aripiprazole, quetiapine, and ziprasidone) were included. On the PANSS scale, aripiprazole (mean difference [MD]: −6.98, 95% CrI: −12.35, −1.38) was statistically more effective than placebo. When assessed by BPRS, aripiprazole (MD: −9.01, 95% CrI: −15.81, −3.12), quetiapine (MD: −7.13, 95% CrI: −9.78, −4.29) and ziprasidone (MD: −4.97, 95% CrI: 9.96, −0.21) had greater efficacy, when compared to placebo. Regarding CGI-S, quetiapine (MD: −0.55, 95% CrI: −0.82, −0.25) was significantly superior to placebo. In terms of acceptability, aripiprazole (OR: 0.54, 95% CrI: 0.41, 0.73), quetiapine (OR: 0.49, 95% CrI: 0.36, 0.68) and ziprasidone (OR: 0.68, 95% CrI: 0.48, 0.96) were more acceptable than placebo. The benefit risk analysis revealed that quetiapine has the best efficacy and acceptability profile among the three prolactin-sparing antipsychotics. Conclusions: Quetiapine may offer an optimal benefit-risk balance when a prolactin-sparing antipsychotic is indicated.

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三种节省催乳素的抗精神病药物对精神分裂症患者的疗效和可接受性:一项网络荟萃分析

背景:本研究旨在系统评价三种节省催乳素的抗精神病药物治疗精神分裂症。方法:我们对精神分裂症患者的三种节省催乳素的抗精神病药物进行了荟萃分析。研究终点为阳性和阴性症状量表(PANSS)、简短精神病学评定量表(BPRS)、临床总体印象-严重程度(CGI-S)和可接受性(全因停药)。结果:共纳入12项试验(2723例患者)，纳入3种药物(阿立哌唑、喹硫平、齐拉西酮)。在PANSS量表上，阿立哌唑(mean difference [MD]:−6.98,95% CrI:−12.35，−1.38)比安慰剂更有效。当BPRS评估时，与安慰剂相比，阿立哌唑(MD: - 9.01, 95% CrI: - 15.81， - 3.12)、喹硫平(MD: - 7.13, 95% CrI: - 9.78， - 4.29)和齐拉西酮(MD: - 4.97, 95% CrI: 9.96， - 0.21)的疗效更好。关于CGI-S，喹硫平(MD: - 0.55, 95% CrI: - 0.82， - 0.25)显著优于安慰剂。在可接受性方面，阿立哌唑(OR: 0.54, 95% CrI: 0.41, 0.73)、喹硫平(OR: 0.49, 95% CrI: 0.36, 0.68)和齐拉西酮(OR: 0.68, 95% CrI: 0.48, 0.96)的可接受性优于安慰剂。获益风险分析显示，在3种保留催乳素的抗精神病药物中，喹硫平的疗效和可接受性最好。结论:当需要保留催乳素的抗精神病药物时，喹硫平可能提供最佳的利益-风险平衡。

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来源期刊

Psychiatry and Clinical Psychopharmacology Medicine-Psychiatry and Mental Health

CiteScore

1.00

自引率

14.30%

发文量

期刊介绍： Psychiatry and Clinical Psychopharmacology aims to reach a national and international audience and will accept submissions from authors worldwide. It gives high priority to original studies of interest to clinicians and scientists in applied and basic neurosciences and related disciplines. Psychiatry and Clinical Psychopharmacology publishes high quality research targeted to specialists, residents and scientists in psychiatry, psychology, neurology, pharmacology, molecular biology, genetics, physiology, neurochemistry, and related sciences.