Prevalence and Predictors of Clozapine-Associated Constipation: A Systematic Review and Meta-Analysis.
Prevalence and Predictors of Clozapine-Associated Constipation: A Systematic Review and Meta-Analysis.
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DOI：
10.3390/ijms17060863
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发表时间：
2016-06-02
影响因子：
5.6
通讯作者：
Lally J
中科院分区：
文献类型：
--
作者：
Shirazi A;Stubbs B;Gomez L;Moore S;Gaughran F;Flanagan RJ;MacCabe JH;Lally J
镇静剂是一种经常被忽视的副作用，氯氮平治疗，可以证明是致命的。我们进行了系统回顾和荟萃分析，以估计氯氮平相关便秘的患病率和危险因素。两位作者对1990年1月至2016年3月期间的主要电子数据库进行了系统检索，以查找报告氯氮平治疗成人便秘患病率的文章。进行了随机效应荟萃分析。共对32项研究进行了荟萃分析，确定氯氮平相关便秘的汇总患病率为31.2%（95% CI：25.6-37.4）（n = 2013）。服用氯氮平的人比其他抗精神病药物更容易便秘（OR 3.02（CI：1.91-4.77），p < 0.001，n = 11项研究）。荟萃回归确定了与便秘患病率相关的两个重要的研究水平因素：显著更高（p = 0.02）观察了住院患者与门诊患者或混合环境中治疗的患者以及便秘是主要或次要结局指标的研究中的便秘发生率（36.9%），而便秘不是特定结局指标的研究（24.8%，p = 0.048）。氯氮平相关的便秘是常见的，大约是其他抗精神病药物的三倍。应建立筛查和预防策略，并在必要时进行适当的对症治疗。
Constipation is a frequently overlooked side effect of clozapine treatment that can prove fatal. We conducted a systematic review and meta-analysis to estimate the prevalence and risk factors for clozapine-associated constipation. Two authors performed a systematic search of major electronic databases from January 1990 to March 2016 for articles reporting the prevalence of constipation in adults treated with clozapine. A random effects meta-analysis was conducted. A total of 32 studies were meta-analyzed, establishing a pooled prevalence of clozapine-associated constipation of 31.2% (95% CI: 25.6–37.4) (n = 2013). People taking clozapine were significantly more likely to be constipated versus other antipsychotics (OR 3.02 (CI: 1.91–4.77), p < 0.001, n = 11 studies). Meta-regression identified two significant study-level factors associated with constipation prevalence: significantly higher (p = 0.02) rates of constipation were observed for those treated in inpatient versus outpatient or mixed settings and for those studies in which constipation was a primary or secondary outcome measure (36.9%) compared to studies in which constipation was not a specified outcome measure (24.8%, p = 0.048). Clozapine-associated constipation is common and approximately three times more likely than with other antipsychotics. Screening and preventative strategies should be established and appropriate symptomatic treatment applied when required.