Comparative efficacy and safety of antipsychotics in the treatment of schizophrenia: a network meta-analysis in a Japanese population

Taro Kishi,1,* Toshikazu Ikuta,2,* Shinji Matsunaga,1 Yuki Matsuda,1,3 Kazuto Oya,1 Nakao Iwata1 1Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Aichi, Japan; 2Department of Communication Sciences and Disorders, School of Applied Sciences, University of Mississippi,...

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Autores principales:	Kishi T, Ikuta T, Matsunaga S, Matsuda Y, Oya K, Iwata N
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	antipsychotics Japanese schizophrenia network meta-analysis efficacy safety Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/bb88ffc58d894d96a00dbcde699962fe
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spelling	oai:doaj.org-article:bb88ffc58d894d96a00dbcde699962fe2021-12-02T11:56:23ZComparative efficacy and safety of antipsychotics in the treatment of schizophrenia: a network meta-analysis in a Japanese population1178-2021https://doaj.org/article/bb88ffc58d894d96a00dbcde699962fe2017-05-01T00:00:00Zhttps://www.dovepress.com/comparative-efficacy-and-safety-of-antipsychotics-in-the-treatment-of--peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Taro Kishi,1,* Toshikazu Ikuta,2,* Shinji Matsunaga,1 Yuki Matsuda,1,3 Kazuto Oya,1 Nakao Iwata1 1Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Aichi, Japan; 2Department of Communication Sciences and Disorders, School of Applied Sciences, University of Mississippi, Oxford, MS, USA; 3Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan *These authors contributed equally to this work Background: The relative efficacy and tolerability of antipsychotics for schizophrenia are considerably well studied. This study aimed to examine whether previous findings could be replicated in a genetically distinct and homogenous group (ie, Japanese patients with schizophrenia) and whether previous findings could be extended to a broader range of antipsychotics with previously unclear relative efficacy and tolerability.Methods: Bayesian network meta-analysis was performed in which randomized trials comparing any of the following interventions were included: second-generation antipsychotics, haloperidol, or placebo. The primary outcomes for efficacy and acceptability were the response rate and all-cause discontinuation. The secondary outcomes included the improvement of Positive and Negative Syndrome Scale scores, discontinuation because of adverse events, and individual adverse events.Results: Eighteen relevant studies were identified (total n=3,446; aripiprazole =267, blonanserin =285, clozapine =47, clocapramine =295, haloperidol =857, mosapramine =493, olanzapine =179, paliperidone =136, perospirone =146, placebo =138, quetiapine =212, and risperidone =338; mean study duration =8.33±1.41 weeks). In primary outcomes, olanzapine and paliperidone showed efficacy than placebo, and olanzapine and paliperidone showed superior acceptability compared with placebo. There were differences in the incidences of individual adverse events (the best antipsychotic: extrapyramidal symptoms = olanzapine, hyperprolactinemia-related symptoms = quetiapine, sedation = paliperidone, and weight change = blonanserin) among antipsychotics.Conclusion: Although the current analysis exclusively included Japanese patients with schizophrenia, no remarkable differences were observed in efficacy and safety compared with previous meta-analyses. Diverse hierarchies in safety outcomes also support the implication that individual risk expectations for adverse events can guide clinical decisions. However, the sample size was relatively limited. Additional efficacy and safety data are required to fully obtain a conclusive understanding. Keywords: antipsychotics, Japanese schizophrenia, network meta-analysis, efficacy, safetyKishi TIkuta TMatsunaga SMatsuda YOya KIwata NDove Medical PressarticleantipsychoticsJapanese schizophrenianetwork meta-analysisefficacysafetyNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 13, Pp 1281-1302 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	antipsychotics Japanese schizophrenia network meta-analysis efficacy safety Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	antipsychotics Japanese schizophrenia network meta-analysis efficacy safety Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Kishi T Ikuta T Matsunaga S Matsuda Y Oya K Iwata N Comparative efficacy and safety of antipsychotics in the treatment of schizophrenia: a network meta-analysis in a Japanese population
description	Taro Kishi,1,* Toshikazu Ikuta,2,* Shinji Matsunaga,1 Yuki Matsuda,1,3 Kazuto Oya,1 Nakao Iwata1 1Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Aichi, Japan; 2Department of Communication Sciences and Disorders, School of Applied Sciences, University of Mississippi, Oxford, MS, USA; 3Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan *These authors contributed equally to this work Background: The relative efficacy and tolerability of antipsychotics for schizophrenia are considerably well studied. This study aimed to examine whether previous findings could be replicated in a genetically distinct and homogenous group (ie, Japanese patients with schizophrenia) and whether previous findings could be extended to a broader range of antipsychotics with previously unclear relative efficacy and tolerability.Methods: Bayesian network meta-analysis was performed in which randomized trials comparing any of the following interventions were included: second-generation antipsychotics, haloperidol, or placebo. The primary outcomes for efficacy and acceptability were the response rate and all-cause discontinuation. The secondary outcomes included the improvement of Positive and Negative Syndrome Scale scores, discontinuation because of adverse events, and individual adverse events.Results: Eighteen relevant studies were identified (total n=3,446; aripiprazole =267, blonanserin =285, clozapine =47, clocapramine =295, haloperidol =857, mosapramine =493, olanzapine =179, paliperidone =136, perospirone =146, placebo =138, quetiapine =212, and risperidone =338; mean study duration =8.33±1.41 weeks). In primary outcomes, olanzapine and paliperidone showed efficacy than placebo, and olanzapine and paliperidone showed superior acceptability compared with placebo. There were differences in the incidences of individual adverse events (the best antipsychotic: extrapyramidal symptoms = olanzapine, hyperprolactinemia-related symptoms = quetiapine, sedation = paliperidone, and weight change = blonanserin) among antipsychotics.Conclusion: Although the current analysis exclusively included Japanese patients with schizophrenia, no remarkable differences were observed in efficacy and safety compared with previous meta-analyses. Diverse hierarchies in safety outcomes also support the implication that individual risk expectations for adverse events can guide clinical decisions. However, the sample size was relatively limited. Additional efficacy and safety data are required to fully obtain a conclusive understanding. Keywords: antipsychotics, Japanese schizophrenia, network meta-analysis, efficacy, safety
format	article
author	Kishi T Ikuta T Matsunaga S Matsuda Y Oya K Iwata N
author_facet	Kishi T Ikuta T Matsunaga S Matsuda Y Oya K Iwata N
author_sort	Kishi T
title	Comparative efficacy and safety of antipsychotics in the treatment of schizophrenia: a network meta-analysis in a Japanese population
title_short	Comparative efficacy and safety of antipsychotics in the treatment of schizophrenia: a network meta-analysis in a Japanese population
title_full	Comparative efficacy and safety of antipsychotics in the treatment of schizophrenia: a network meta-analysis in a Japanese population
title_fullStr	Comparative efficacy and safety of antipsychotics in the treatment of schizophrenia: a network meta-analysis in a Japanese population
title_full_unstemmed	Comparative efficacy and safety of antipsychotics in the treatment of schizophrenia: a network meta-analysis in a Japanese population
title_sort	comparative efficacy and safety of antipsychotics in the treatment of schizophrenia: a network meta-analysis in a japanese population
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/bb88ffc58d894d96a00dbcde699962fe
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Comparative efficacy and safety of antipsychotics in the treatment of schizophrenia: a network meta-analysis in a Japanese population

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