TY - JOUR
T1 - Efficacy, Tolerability, and Safety of Blonanserin in Schizophrenia
T2 - An Updated and Extended Systematic Review and Meta-Analysis of Randomized Controlled Trials
AU - Kishi, Taro
AU - Matsui, Yuki
AU - Matsuda, Yuki
AU - Katsuki, Asuka
AU - Hori, Hikaru
AU - Yanagimoto, Hiroko
AU - Sanada, Kenji
AU - Morita, Kiichiro
AU - Yoshimura, Reiji
AU - Shoji, Yoshihisa
AU - Hagi, Katsuhiko
AU - Iwata, Nakao
N1 - Funding Information:
ics in patients with schizophrenia. The risk of bias is presented in Table S1. Overall, the RCTs often did not provide details regarding blinding procedures. The study quality of the RCTs in this systematic review was moderately satisfactory. Three RCTs received a Jadad score of 5 [21, 23, 24], which is indicative of excellent quality; 1 RCT had a score of 4 [1], and 3 RCTs had a score of 3. Three RCTs received a Jadad score of 2. The mean Jadad score for all RCTs in our analysis was 3.4 (Table S1). Five RCTs were double-blinded studies, 2 were rater-blinded studies [2, 11], and 3 were open-label studies [8–10]. Although 5 RCTs were sponsored by pharmaceutical companies [1, 21–24], 5 were publicly funded. The characteristics of all the included studies are shown in 0Table 1.
Funding Information:
We thank Dr. Kenji Sanada (Department of Psychiatry, Showa University School of Medicine, Tokyo, Japan), Dr. Kiichiro Morita (Cognitive and Molecular Research Institute of Brain Diseases, Kurume University, Kurume, Fukuoka, Japan), and Dr. Hikaru Hori (Department of Psychiatry, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan) for providing unpublished data.
Publisher Copyright:
© Georg Thieme Verlag KG Stuttgart New York.
PY - 2019/3/7
Y1 - 2019/3/7
N2 - 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 (n = 1521) 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, p = 0.003). Blonanserin was associated with a higher incidence of all-cause discontinuation (RR = 1.373, 95% CI = 1.088-1.734, p = 0.008, NNH = 11), 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.
AB - 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 (n = 1521) 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, p = 0.003). Blonanserin was associated with a higher incidence of all-cause discontinuation (RR = 1.373, 95% CI = 1.088-1.734, p = 0.008, NNH = 11), 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.
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U2 - 10.1055/a-0574-0088
DO - 10.1055/a-0574-0088
M3 - Article
C2 - 29514360
AN - SCOPUS:85043348163
VL - 52
SP - 52
EP - 62
JO - Pharmakopsychiatrie und Neuropsychopharmakologie
JF - Pharmakopsychiatrie und Neuropsychopharmakologie
SN - 0176-3679
IS - 2
ER -