Efficacy and Tolerability of Histamine-2 Receptor Antagonist Adjunction of Antipsychotic Treatment in Schizophrenia: A Meta-analysis of Randomized Placebo-controlled Trials
Efficacy and Tolerability of Histamine-2 Receptor Antagonist Adjunction of Antipsychotic Treatment in Schizophrenia: A Meta-analysis of Randomized Placebo-controlled Trials
复制标题
DOI：
10.1055/s-0034-1390478
复制
发表时间：
2015-01-01
影响因子：
4.3
通讯作者：
Iwata, N.
中科院分区：
文献类型：
--
作者：
Kishi, T.;Iwata, N.
简介：尚未进行关于组胺-2受体拮抗剂连续治疗的有效性和耐受性的综合荟萃分析方法：计算危险比、标准化均值差（SMD）和95%可信区间。结果：我们纳入了8项符合纳入标准的双盲、随机安慰剂对照试验（RCT）（n = 418）（法莫替丁：N = 3，n = 74;尼扎替丁：N = 4，n = 292;雷尼替丁：N = 1，n = 52）。合并的H2R-ANT在总体症状和体重减轻方面与安慰剂没有差异。然而，合并的H2R-ANT导致比安慰剂更低的体重指数（BMI）（SMD =-0.68）。此外，尼扎替丁与血浆瘦素水平的增加有关（SMD =-1.14）。在合并的H2R-ANT和安慰剂之间，由于全因、副作用和无效而导致的停药率没有显著差异。然而，尼扎替丁比安慰剂产生更多的抑郁和口干。讨论：H2R-ANT连续治疗没有改善整体症状。为了澄清体重和BMI之间的相反结果，未来的研究应该调查长期疗效，并通过使用更大的样本产生更多的安全性数据。
Introduction: No comprehensive meta-analysis has been performed concerning the efficacy and tolerability of adjunctive therapy with histamine-2 receptor antagonists (H2R-ANTs) in schizophrenia patients who were treated with antipsychotics.Methods: Risk ratios, standardized mean differences (SMD), and 95% confidence intervals were calculated.Results: We included 8 double-blinded, randomized placebo-controlled trials (RCTs) (n=418) that met the inclusion criteria (famotidine: N=3, n=74; nizatidine: N=4, n=292; ranitidine: N=1, n=52). Pooled H2R-ANTs were not different from placebo with regard to reduction in overall symptoms and body weight. However, pooled H2R-ANTs resulted in lower body mass index (BMI) than placebo (SMD=-0.68). Moreover, nizatidine was associated with an increase in plasma leptin levels (SMD=-1.14). There were no significant differences in the discontinuation rates due to all-cause, side effects, and inefficacy between pooled H2R-ANTs and placebo. However, nizatidine produced more depression and dry mouth than placebo.Discussion: H2R-ANT adjunctive therapy did not improve overall symptoms. To clarify the opposite results between body weight and BMI, future research should investigate long-term efficacy and generate more safety data by using larger samples.