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在精神分裂症中使用布南色林的疗效、耐受性和安全性:一项更新和扩展的随机对照试验的系统评价和荟萃分析。

Efficacy, Tolerability, and Safety of Blonanserin in Schizophrenia: An Updated and Extended Systematic Review and Meta-Analysis of Randomized Controlled Trials.

机构信息

Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Aichi, Japan.

Department of Psychiatry, Jikei University School of Medicine, Minato-ku, Tokyo, Japan.

出版信息

Pharmacopsychiatry. 2019 Feb;52(2):52-62. doi: 10.1055/a-0574-0088. Epub 2018 Mar 7.

Abstract

INTRODUCTION

We conducted an updated systematic review and meta-analysis of randomized controlled trials (RCTs) comparing blonanserin with other antipsychotics (amisulpride, aripiprazole, haloperidol, paliperidone, and risperidone).

METHODS

Weighted mean difference (WMD), risk ratio, and number needed to harm (NNH) with 95% confidence intervals (95% CIs) were calculated using random-effects model.

RESULTS

Ten RCTs (n1521) were included in this study. Blonanserin was superior to aripiprazole in improvement of Positive and Negative Syndrome Scale total scores (WMD-10.62, 95% CI-17.67 to -3.560, p0.003). Blonanserin was associated with a higher incidence of all-cause discontinuation (RR1.373, 95% CI1.088-1.734, p0.008, NNH11), akathisia, extrapyramidal disorder, and agitation/excitement and a lower risk of hyperprolactinemia compared with risperidone + paliperidone.

DISCUSSION

The current meta-analytic study did not update the comparison of blonanserin vs. haloperidol because there were no new RCTs. Our results suggest that the efficacy of blonanserin for schizophrenia is comparable with that of other antipsychotics, and blonanserin seems to be well tolerated.

摘要

简介

我们进行了一项更新的系统评价和荟萃分析,比较了布南色林与其他抗精神病药物(氨磺必利、阿立哌唑、氟哌啶醇、帕利哌酮和利培酮)的随机对照试验(RCT)。

方法

使用随机效应模型计算加权均数差(WMD)、风险比(RR)和需要治疗的人数(NNH)及其 95%置信区间(95%CI)。

结果

本研究纳入了 10 项 RCT(n1521)。布南色林在改善阳性和阴性症状量表总分方面优于阿立哌唑(WMD-10.62,95%CI-17.67 至-3.560,p0.003)。布南色林与全因停药(RR1.373,95%CI1.088-1.734,p0.008,NNH11)、静坐不能、锥体外系疾病和激动/兴奋的发生率较高,与利培酮+帕利哌酮相比,高催乳素血症的风险较低。

讨论

本荟萃分析研究没有更新布南色林与氟哌啶醇的比较,因为没有新的 RCT。我们的研究结果表明,布南色林治疗精神分裂症的疗效与其他抗精神病药物相当,且布南色林似乎具有良好的耐受性。

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