Aripiprazole for the management of schizophrenia in the Japanese population: a systematic review and meta-analysis of randomized controlled trials.
Aripiprazole for the management of schizophrenia in the Japanese population: a systematic review and meta-analysis of randomized controlled trials.
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DOI：
10.2147/ndt.s78977
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发表时间：
2015
影响因子：
3.2
通讯作者：
Iwata N
中科院分区：
文献类型：
--
作者：
Kishi T;Matsuda Y;Matsunaga S;Iwata N
我们对在日本精神分裂症患者中比较阿立哌唑与汇总抗精神病药的随机对照试验进行了系统回顾和荟萃分析。我们对截至2014年1月5日发表在PubMed®、科克伦图书馆数据库、日本医学文摘协会和PsycINFO®上的数据进行了文献检索。根据随机效应模型计算比值比（OR）、需要伤害的人数（NNH）和标准化平均差（SMD）。我们确定了5项相关研究（7项比较，n=684;氟哌啶醇[n=243]、莫沙帕明[n=238]、奥氮平[n=39]、奎替鲁[n=42]、哌罗匹隆[n=100]各1项比较，利培酮[n=66] 2项比较）。阿立哌唑和汇总抗精神病药之间的阳性和阴性症状量表（PANSS）总分、阴性和一般评分（SMD=0.10，SMD=-0.09，SMD=0.10）;与所有原因相关的停药率（OR=1.35）;或副作用（OR=1.03）无显著差异。在PANSS阳性子量表评分（SMD=0.17）和因无效而停药（OR=2.21，NNH=11）方面，阿立哌唑劣于合并的抗精神病药物。然而，与合并的抗精神病药相比，阿立哌唑的副作用较少（一种或多种副作用的OR=0.21，NNH=20），包括疲劳（OR=0.22，NNH=8），高泌乳素血症（OR=0.00，NNH=1），锥体外系症状（OR=0.46，NNH=6）和体重增加（OR=0.36，NNH=7）。此外，与合并的抗精神病药物相比，阿立哌唑与较低的总胆固醇（SMD=-0.20）和甘油三酯（SMD=-0.17）水平和体重（SMD=-0.20）相关。尽管阿立哌唑组与无效相关的停药率高于合并抗精神病药组，但与合并抗精神病药组相比，阿立哌唑与高泌乳素血症、代谢和锥体外系症状的风险较低相关。
We conducted a systematic review and meta-analysis of randomized controlled trials comparing aripiprazole with pooled antipsychotics in Japanese patients with schizophrenia. We performed a literature search of data published in PubMed®, the Cochrane Library database, the Japan Medical Abstracts Society, and PsycINFO® up to January 5, 2014. The odds ratio (OR), number-needed-to-harm (NNH), and standardized mean difference (SMD) based on a random effects model were calculated. We identified five relevant studies (seven comparisons, n=684; one comparison each for haloperidol [n=243], mosapramine [n=238], olanzapine [n=39], quetiapine [n=42], perospirone [n=100], and two comparisons for risperidone [n=66]). There were no significant differences in the Positive and Negative Syndrome Scale (PANSS) total, negative, and general scores (SMD=0.10, SMD=−0.09, SMD=0.10, respectively); discontinuation rate associated with all causes (OR=1.35); or side effects (OR=1.03) between aripiprazole and the pooled antipsychotics. Aripiprazole was inferior to the pooled antipsychotics in PANSS positive subscale scores (SMD=0.17) and discontinuation because of inefficacy (OR=2.21, NNH=11). However, aripiprazole had fewer side effects compared with the pooled antipsychotics (OR=0.21, NNH=20 for one or more side effects), including fatigue (OR=0.22, NNH=8), hyperprolactinemia (OR=0.00, NNH=1), extrapyramidal symptoms (OR=0.46, NNH=6), and weight gain (OR=0.36, NNH=7). Moreover, aripiprazole was associated with lower total cholesterol (SMD=−0.20) and triglyceride (SMD=−0.17) levels and body weight (SMD=−0.20) compared with the pooled antipsychotics. Although the discontinuation rate associated with inefficacy was higher with aripiprazole than with the pooled antipsychotics, aripiprazole was associated with a lower risk of hyperprolactinemia and metabolic and extrapyramidal symptoms compared with the pooled antipsychotics.