Comparative Efficacy of First and Second Generation long-acting injectable antipsychotic upon schizophrenic patients: a systematic review and network meta-analysis
DOI:
https://doi.org/10.31157/an.v28i2.432Keywords:
schizophrenia, antipsychotics., Long-acting injectable antipsychoticsAbstract
Introduction: Long-acting injectable antipsychotics (LAIA) can lead the course of treatment with the potential to increase adherence in schizophrenia treatment. The objective of this systematic review and network meta-analysis is to find the efficacy of SG-LAIAs, FG-LAIAs compared to each other for schizophrenia.
Methods: This systematic review and network meta-analysis was designed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), with registration in Prospero (ID CRD42019128700). A database in MEDLINE, EMBASE, Web of Science, and Scopus, until June 17, 2020, with an actualization from June 2020 to September 14, 2021.
Results: The SMDs for the four (80%) antipsychotics that significantly reduced PANSS score compared with placebo ranged between –0·72 (95% CrI –0·99 to –0·46) for haloperidol to –0·45 (–0·54 to –0·37) for paliperidone. 8 studies reported usable results for negative symptoms and positive symptoms (Four antipsychotics compared). The SMDs for the three (75%) antipsychotics that significantly reduced negative symptoms compared with placebo ranged between –0·40 (95% CrI –0·53 to –0·26) for aripiprazole to –0·32 (–0·44 to –0·19) for risperidone. The SMDs for the three (100%) drugs that significantly reduced positive symptoms compared with placebo ranged between –0·50 (95% CrI –0·63 to –0·37) for aripiprazole to –0·19 (–0·57 to 0·20) for zuclopenthixol.
Discussion: We found evidence suggesting that all long-acting injectable antipsychotics, except for zuclopenthixol, are equally efficient in reducing symptoms in schizophrenia,
Conclusions: Most LAIAs are equally efficient at reducing overall symptoms, and differences between individual LAIAs are non-significant.
References
Brown A, Lau F. Chapter 2 - A Review of the Epidemiology of Schizophrenia. Handb Behav Neurosci. 2016;23:17–30. DOI: https://doi.org/10.1016/B978-0-12-800981-9.00002-X
World Health Organization. Schizophrenia. WHO.
Collins PY, Patel V, Joestl SS, March D, Insel TR, Daar AS, et al. Grand Challenges in Global Mental Health. Nature. 2011;7–10.
Karadag F, Sengul CB, Enli Y, Karakulah K, Alacam H, Kaptanoglu B, et al. Relationship between serum bilirubin levels and metabolic syndrome in patients with schizophrenia spectrum disorders. Clin Psychopharmacol Neurosci. 2017;15(2):153–62. DOI: https://doi.org/10.9758/cpn.2017.15.2.153
Kim YK, Choi J, Park SC. A novel bio-psychosocial-behavioral treatment model in schizophrenia. Int J Mol Sci. 2017;18(4). DOI: https://doi.org/10.3390/ijms18040734
Tripathi A, Kar SK, Shukla R. Cognitive deficits in schizophrenia: Understanding the biological correlates and remediation strategies. Clin Psychopharmacol Neurosci. 2018;16(1):7–17. DOI: https://doi.org/10.9758/cpn.2018.16.1.7
Chesney E, Goodwin G, Fazel S. Risks of all-cause and suicide mortality in mental disorders: a meta-review. World Psychiatry. 2014;13(2):153–60. DOI: https://doi.org/10.1002/wps.20128
Barkhof E, Meijer CJ, de Sonneville LMJ, Linszen DH, de Haan L. Interventions to improve adherence to antipsychotic medication in patients with schizophrenia-A review of the past decade. Eur Psychiatry [Internet]. 2012;27(1):9–18. Available from: http://dx.doi.org/10.1016/j.eurpsy.2011.02.005 DOI: https://doi.org/10.1016/j.eurpsy.2011.02.005
Kishimoto T, Nitta M, Borenstein M, Kane JM, Correll CU. Long-acting injectable versus oral antipsychotics in schizophrenia: A systematic review and meta-analysis of mirror-image studies. J Clin Psychiatry. 2013;74(10):957–65. DOI: https://doi.org/10.4088/JCP.13r08440
Leucht C, Heres S, Kane J, Kissling W, Davis J, Leucht S. Oral versus depot antipsychotic drugs for schizophrenia--a critical systematic review and meta-analysis of randomised long-term trials. Schizophr Res. 2011;127(1–3):83–92. DOI: https://doi.org/10.1016/j.schres.2010.11.020
Park SC, Choi MY, Choi J, Park E, Tchoe HJ, Suh JK, et al. Comparative efficacy and safety of long-Acting injectable and oral second-generation antipsychotics for the treatment of schizophrenia: A systematic review and meta-Analysis. Clin Psychopharmacol Neurosci. 2018;16(4):361–75. DOI: https://doi.org/10.9758/cpn.2018.16.4.361
Kishi T, Matsunaga S, Iwata N. Mortality Risk Associated with Long-acting Injectable Antipsychotics: A Systematic Review and Meta-analyses of Randomized Controlled Trials. Schizophr Bull. 2016;42(6):1438–45. DOI: https://doi.org/10.1093/schbul/sbw043
Gentile S. Discontinuation rates during long-term, second-generation antipsychotic long-acting injection treatment: A systematic review. Psychiatry Clin Neurosci. 2019;73(5):216–30. DOI: https://doi.org/10.1111/pcn.12824
Saucedo E, Carranza F, Fernanda A, Medrano G, Iscely K, Cervantes G, et al. Preliminary efficacy and tolerability profiles of first versus second-generation Long-Acting Injectable Antipsychotics in schizophrenia : A systematic review and meta-analysis. 2020;129(March):222–33. DOI: https://doi.org/10.1016/j.jpsychires.2020.06.013
Falotico R, Quatto P. Fleiss ’ kappa statistic without paradoxes. 2014;(ii). DOI: https://doi.org/10.1007/s11135-014-0003-1
Leucht S, Davis JM, Engel RR, Kissling W, Kane JM. Definitions of response and remission in schizophrenia: Recommendations for their use and their presentation. Acta Psychiatr Scand. 2009;119(SUPPL. 438):7–14. DOI: https://doi.org/10.1111/j.1600-0447.2008.01308.x
Schennach-Wolff R, Seemüller FH, Mayr A, Maier W, Klingberg S, Heuser I, et al. An early improvement threshold to predict response and remission in first-episode schizophrenia. Br J Psychiatry. 2010;196(6):460–6. DOI: https://doi.org/10.1192/bjp.bp.109.069328
Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ WV. Cochrane Handbook for Systematic Reviews of Interventions version 6.0 (updated July 2019). Cochrane. 2019. DOI: https://doi.org/10.1002/9781119536604
Guyatt GH. GRADE : an emerging consensus on rating quality of evidence and strength of recommendations. 2008;336(April). DOI: https://doi.org/10.1136/bmj.39489.470347.AD
Puhan MA, Murad MH, Li T, Singh JA, Kessels AG, Guyatt GH, et al. RESEARCH METHODS & REPORTING A GRADE Working Group approach for rating the. 2014;5630(September):1–10. DOI: https://doi.org/10.1136/bmj.g5630
Marder SR, Kirkpatrick B. Defining and measuring negative symptoms of schizophrenia in clinical trials. Eur Neuropsychopharmacol [Internet]. 2014;24(5):737–43. Available from: http://dx.doi.org/10.1016/j.euroneuro.2013.10.016 DOI: https://doi.org/10.1016/j.euroneuro.2013.10.016
Downloads
Additional Files
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
September 2022-present © Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez. Open access articles under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) license, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. No commercial re-use is allowed.
January-September 2022 © The authors. Open access articles under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) license, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. No commercial re-use is allowed.
January 2014-December 2021 © Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez. Open access articles under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) license, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
