Aripiprazole for the management of schizophrenia in the japanese population: A systematic review and meta-analysis of randomized controlled trials

Taro Kishi, Yuki Matsuda, Shinji Matsunaga, Nakao Iwata

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: We conducted a systematic review and meta-analysis of randomized controlled trials comparing aripiprazole with pooled antipsychotics in Japanese patients with schizophrenia. Methods: 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. Results: We identifed fve 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 signifcant 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 ineffcacy (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), hyperpro-lactinemia (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. Conclusion: Although the discontinuation rate associated with ineffcacy 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.

Original languageEnglish
Pages (from-to)419-434
Number of pages16
JournalNeuropsychiatric Disease and Treatment
Volume11
DOIs
Publication statusPublished - 20-02-2015

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Meta-Analysis
Schizophrenia
Randomized Controlled Trials
Odds Ratio
Antipsychotic Agents
Population
olanzapine
Aripiprazole
Hyperprolactinemia
Risperidone
Medical Societies
Haloperidol
PubMed
Libraries
Weight Gain
Fatigue
Japan
Triglycerides
Cholesterol
Body Weight

All Science Journal Classification (ASJC) codes

  • Psychiatry and Mental health
  • Biological Psychiatry

Cite this

@article{c44d17fbd030412489aae0af2d0abaa5,
title = "Aripiprazole for the management of schizophrenia in the japanese population: A systematic review and meta-analysis of randomized controlled trials",
abstract = "Background: We conducted a systematic review and meta-analysis of randomized controlled trials comparing aripiprazole with pooled antipsychotics in Japanese patients with schizophrenia. Methods: We performed a literature search of data published in PubMed{\circledR}, the Cochrane Library database, the Japan Medical Abstracts Society, and PsycINFO{\circledR} 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. Results: We identifed fve 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 signifcant 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 ineffcacy (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), hyperpro-lactinemia (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. Conclusion: Although the discontinuation rate associated with ineffcacy 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.",
author = "Taro Kishi and Yuki Matsuda and Shinji Matsunaga and Nakao Iwata",
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Aripiprazole for the management of schizophrenia in the japanese population : A systematic review and meta-analysis of randomized controlled trials. / Kishi, Taro; Matsuda, Yuki; Matsunaga, Shinji; Iwata, Nakao.

In: Neuropsychiatric Disease and Treatment, Vol. 11, 20.02.2015, p. 419-434.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Aripiprazole for the management of schizophrenia in the japanese population

T2 - A systematic review and meta-analysis of randomized controlled trials

AU - Kishi, Taro

AU - Matsuda, Yuki

AU - Matsunaga, Shinji

AU - Iwata, Nakao

PY - 2015/2/20

Y1 - 2015/2/20

N2 - Background: We conducted a systematic review and meta-analysis of randomized controlled trials comparing aripiprazole with pooled antipsychotics in Japanese patients with schizophrenia. Methods: 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. Results: We identifed fve 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 signifcant 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 ineffcacy (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), hyperpro-lactinemia (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. Conclusion: Although the discontinuation rate associated with ineffcacy 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.

AB - Background: We conducted a systematic review and meta-analysis of randomized controlled trials comparing aripiprazole with pooled antipsychotics in Japanese patients with schizophrenia. Methods: 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. Results: We identifed fve 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 signifcant 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 ineffcacy (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), hyperpro-lactinemia (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. Conclusion: Although the discontinuation rate associated with ineffcacy 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.

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