Comparison of the efficacy and safety of 4 and 2 mg/day brexpiprazole for acute schizophrenia: a meta-analysis of double-blind, randomized placebo-controlled trials

Taro Kishi,1 Kazuto Oya,1 Yuki Matsui,1,2 Ikuo Nomura,1 Kenji Sakuma,1 Makoto Okuya,1 Yuki Matsuda,3 ,Kiyoshi Fujita,4 Toshihiko Funahashi,2 Reiji Yoshimura,5 Nakao Iwata1 1Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Aichi 470-1192, Japan; 2Department of Psychiat...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Kishi T, Oya K, Matsui Y, Nomura I, Sakuma K, Okuya M, Matsuda Y, Fujita K, Funahashi T, Yoshimura R, Iwata N
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	schizophrenia brexpiprazole 2mg/day brexpiprazole 4mg/day efficacy safety systematic review and meta-analysis Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/9dc82aa5f11f42a6af99f9d13f91ddac
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:9dc82aa5f11f42a6af99f9d13f91ddac
record_format	dspace
spelling	oai:doaj.org-article:9dc82aa5f11f42a6af99f9d13f91ddac2021-12-02T07:33:28ZComparison of the efficacy and safety of 4 and 2 mg/day brexpiprazole for acute schizophrenia: a meta-analysis of double-blind, randomized placebo-controlled trials1178-2021https://doaj.org/article/9dc82aa5f11f42a6af99f9d13f91ddac2018-10-01T00:00:00Zhttps://www.dovepress.com/comparison-of-the-efficacy-and-safety-of-4-and-2-mgday-brexpiprazole-f-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Taro Kishi,1 Kazuto Oya,1 Yuki Matsui,1,2 Ikuo Nomura,1 Kenji Sakuma,1 Makoto Okuya,1 Yuki Matsuda,3 ,Kiyoshi Fujita,4 Toshihiko Funahashi,2 Reiji Yoshimura,5 Nakao Iwata1 1Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Aichi 470-1192, Japan; 2Department of Psychiatry, Jindai Hospital, Toyota, Aichi 470-0361, Japan; 3Department of Psychiatry, Jikei University School of Medicine, Minato-ku, Tokyo105-8461, Japan; 4Department of Psychiatry, Okehazama hospital, Toyoake, Aichi 470-1168, Japan; 5Department of Psychiatry, University of Occupational and Environmental Health, Yahatanishi-ku, Kitakyushu, Fukuoka 807-8555, Japan Purpose: The purpose of this study was to compare the efficacy and safety of brexpiprazole 4 mg/day (B4) and 2 mg/day (B2) for treating acute schizophrenia. Patients and methods: We performed three categorical meta-analyses (B4 vs placebo, B2 vs placebo, and B4 vs B2) of double-blind, randomized placebo-controlled trials (DBRCTs) that reported improvements in the Positive and Negative Syndrome Scale (PANSS) scores, response rate, Clinical Global Impression–Improvement and Severity (CGI-I and CGI-S) scores, discontinuation rate, and incidence of individual adverse events. Results: We identified three DBRCTs with 1,444 patients. Both B4 and B2 were superior to placebo for PANSS total score (B4: standardized mean difference [SMD] =-0.30, 95% CI =-0.43, -0.17; B2: SMD =-0.30, 95% CI =-0.46, -0.13), PANSS negative score, response rate, CGI-S score, and CGI-I score. B2, but not B4, was superior to placebo for the PANSS positive score. However, there was considerable heterogeneity in the meta-analysis for B4’s PANSS positive score, which disappeared after excluding a 2018 Japanese study from the meta-analysis that included more patients on a high-dose antipsychotic prior to their participation. A meta-analysis that excluded the data from the abovementioned patients showed B4 to be superior to the placebo in terms of the PANSS positive score (SMD =-0.22, 95% CI =-0.40, -0.03). B2, but not B4, was associated with a lower incidence of all-cause discontinuation compared with placebo. Both B4 and B2 were superior to placebo for discontinuation due to adverse events and schizophrenia, but both were associated with a higher incidence of weight gain compared with placebo. B4 was also associated with a higher risk of extrapyramidal symptoms than B2. Conclusion: Both B4 and B2 benefitted patients with schizophrenia, particularly those who were not previously on high-dose antipsychotics. Both the regimens were well-tolerated, but carried a risk of weight gain and extrapyramidal symptoms, although the latter risk was higher for B4 than B2. Keywords: schizophrenia, brexpiprazole 2 mg/day, brexpiprazole 4 mg/day, Positive and Negative Syndrome Scale score, response rate, safety outcomes, systematic review, meta-analysisKishi TOya KMatsui YNomura ISakuma KOkuya MMatsuda YFujita KFunahashi TYoshimura RIwata NDove Medical Pressarticleschizophreniabrexpiprazole 2mg/daybrexpiprazole 4mg/dayefficacysafetysystematic review and meta-analysisNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 14, Pp 2519-2530 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	schizophrenia brexpiprazole 2mg/day brexpiprazole 4mg/day efficacy safety systematic review and meta-analysis Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	schizophrenia brexpiprazole 2mg/day brexpiprazole 4mg/day efficacy safety systematic review and meta-analysis Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Kishi T Oya K Matsui Y Nomura I Sakuma K Okuya M Matsuda Y Fujita K Funahashi T Yoshimura R Iwata N Comparison of the efficacy and safety of 4 and 2 mg/day brexpiprazole for acute schizophrenia: a meta-analysis of double-blind, randomized placebo-controlled trials
description	Taro Kishi,1 Kazuto Oya,1 Yuki Matsui,1,2 Ikuo Nomura,1 Kenji Sakuma,1 Makoto Okuya,1 Yuki Matsuda,3 ,Kiyoshi Fujita,4 Toshihiko Funahashi,2 Reiji Yoshimura,5 Nakao Iwata1 1Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Aichi 470-1192, Japan; 2Department of Psychiatry, Jindai Hospital, Toyota, Aichi 470-0361, Japan; 3Department of Psychiatry, Jikei University School of Medicine, Minato-ku, Tokyo105-8461, Japan; 4Department of Psychiatry, Okehazama hospital, Toyoake, Aichi 470-1168, Japan; 5Department of Psychiatry, University of Occupational and Environmental Health, Yahatanishi-ku, Kitakyushu, Fukuoka 807-8555, Japan Purpose: The purpose of this study was to compare the efficacy and safety of brexpiprazole 4 mg/day (B4) and 2 mg/day (B2) for treating acute schizophrenia. Patients and methods: We performed three categorical meta-analyses (B4 vs placebo, B2 vs placebo, and B4 vs B2) of double-blind, randomized placebo-controlled trials (DBRCTs) that reported improvements in the Positive and Negative Syndrome Scale (PANSS) scores, response rate, Clinical Global Impression–Improvement and Severity (CGI-I and CGI-S) scores, discontinuation rate, and incidence of individual adverse events. Results: We identified three DBRCTs with 1,444 patients. Both B4 and B2 were superior to placebo for PANSS total score (B4: standardized mean difference [SMD] =-0.30, 95% CI =-0.43, -0.17; B2: SMD =-0.30, 95% CI =-0.46, -0.13), PANSS negative score, response rate, CGI-S score, and CGI-I score. B2, but not B4, was superior to placebo for the PANSS positive score. However, there was considerable heterogeneity in the meta-analysis for B4’s PANSS positive score, which disappeared after excluding a 2018 Japanese study from the meta-analysis that included more patients on a high-dose antipsychotic prior to their participation. A meta-analysis that excluded the data from the abovementioned patients showed B4 to be superior to the placebo in terms of the PANSS positive score (SMD =-0.22, 95% CI =-0.40, -0.03). B2, but not B4, was associated with a lower incidence of all-cause discontinuation compared with placebo. Both B4 and B2 were superior to placebo for discontinuation due to adverse events and schizophrenia, but both were associated with a higher incidence of weight gain compared with placebo. B4 was also associated with a higher risk of extrapyramidal symptoms than B2. Conclusion: Both B4 and B2 benefitted patients with schizophrenia, particularly those who were not previously on high-dose antipsychotics. Both the regimens were well-tolerated, but carried a risk of weight gain and extrapyramidal symptoms, although the latter risk was higher for B4 than B2. Keywords: schizophrenia, brexpiprazole 2 mg/day, brexpiprazole 4 mg/day, Positive and Negative Syndrome Scale score, response rate, safety outcomes, systematic review, meta-analysis
format	article
author	Kishi T Oya K Matsui Y Nomura I Sakuma K Okuya M Matsuda Y Fujita K Funahashi T Yoshimura R Iwata N
author_facet	Kishi T Oya K Matsui Y Nomura I Sakuma K Okuya M Matsuda Y Fujita K Funahashi T Yoshimura R Iwata N
author_sort	Kishi T
title	Comparison of the efficacy and safety of 4 and 2 mg/day brexpiprazole for acute schizophrenia: a meta-analysis of double-blind, randomized placebo-controlled trials
title_short	Comparison of the efficacy and safety of 4 and 2 mg/day brexpiprazole for acute schizophrenia: a meta-analysis of double-blind, randomized placebo-controlled trials
title_full	Comparison of the efficacy and safety of 4 and 2 mg/day brexpiprazole for acute schizophrenia: a meta-analysis of double-blind, randomized placebo-controlled trials
title_fullStr	Comparison of the efficacy and safety of 4 and 2 mg/day brexpiprazole for acute schizophrenia: a meta-analysis of double-blind, randomized placebo-controlled trials
title_full_unstemmed	Comparison of the efficacy and safety of 4 and 2 mg/day brexpiprazole for acute schizophrenia: a meta-analysis of double-blind, randomized placebo-controlled trials
title_sort	comparison of the efficacy and safety of 4 and 2 mg/day brexpiprazole for acute schizophrenia: a meta-analysis of double-blind, randomized placebo-controlled trials
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/9dc82aa5f11f42a6af99f9d13f91ddac
work_keys_str_mv	AT kishit comparisonoftheefficacyandsafetyof4and2mgdaybrexpiprazoleforacuteschizophreniaametaanalysisofdoubleblindrandomizedplacebocontrolledtrials AT oyak comparisonoftheefficacyandsafetyof4and2mgdaybrexpiprazoleforacuteschizophreniaametaanalysisofdoubleblindrandomizedplacebocontrolledtrials AT matsuiy comparisonoftheefficacyandsafetyof4and2mgdaybrexpiprazoleforacuteschizophreniaametaanalysisofdoubleblindrandomizedplacebocontrolledtrials AT nomurai comparisonoftheefficacyandsafetyof4and2mgdaybrexpiprazoleforacuteschizophreniaametaanalysisofdoubleblindrandomizedplacebocontrolledtrials AT sakumak comparisonoftheefficacyandsafetyof4and2mgdaybrexpiprazoleforacuteschizophreniaametaanalysisofdoubleblindrandomizedplacebocontrolledtrials AT okuyam comparisonoftheefficacyandsafetyof4and2mgdaybrexpiprazoleforacuteschizophreniaametaanalysisofdoubleblindrandomizedplacebocontrolledtrials AT matsuday comparisonoftheefficacyandsafetyof4and2mgdaybrexpiprazoleforacuteschizophreniaametaanalysisofdoubleblindrandomizedplacebocontrolledtrials AT fujitak comparisonoftheefficacyandsafetyof4and2mgdaybrexpiprazoleforacuteschizophreniaametaanalysisofdoubleblindrandomizedplacebocontrolledtrials AT funahashit comparisonoftheefficacyandsafetyof4and2mgdaybrexpiprazoleforacuteschizophreniaametaanalysisofdoubleblindrandomizedplacebocontrolledtrials AT yoshimurar comparisonoftheefficacyandsafetyof4and2mgdaybrexpiprazoleforacuteschizophreniaametaanalysisofdoubleblindrandomizedplacebocontrolledtrials AT iwatan comparisonoftheefficacyandsafetyof4and2mgdaybrexpiprazoleforacuteschizophreniaametaanalysisofdoubleblindrandomizedplacebocontrolledtrials
_version_	1718399353532448768

Comparison of the efficacy and safety of 4 and 2 mg/day brexpiprazole for acute schizophrenia: a meta-analysis of double-blind, randomized placebo-controlled trials

Ejemplares similares