Efficacy, Tolerability, and Safety of Blonanserin in Schizophrenia

An Updated and Extended Systematic Review and Meta-Analysis of Randomized Controlled Trials

Taro Kishi, Yuki Matsui, Yuki Matsuda, Asuka Katsuki, Hikaru Hori, Hiroko Yanagimoto, Kenji Sanada, Kiichiro Morita, Reiji Yoshimura, Yoshihisa Shoji, Katsuhiko Hagi, Nakao Iwata

Research output: Contribution to journalArticle

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Abstract

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.

Original languageEnglish
Pages (from-to)52-62
Number of pages11
JournalPharmacopsychiatry
Volume52
Issue number2
DOIs
Publication statusPublished - 07-03-2019

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Meta-Analysis
Schizophrenia
Randomized Controlled Trials
Safety
Risperidone
Haloperidol
Confidence Intervals
Antipsychotic Agents
Basal Ganglia Diseases
Psychomotor Agitation
Hyperprolactinemia
blonanserin
Odds Ratio
Incidence
Aripiprazole
Paliperidone Palmitate

All Science Journal Classification (ASJC) codes

  • Psychiatry and Mental health
  • Pharmacology (medical)

Cite this

Kishi, Taro ; Matsui, Yuki ; Matsuda, Yuki ; Katsuki, Asuka ; Hori, Hikaru ; Yanagimoto, Hiroko ; Sanada, Kenji ; Morita, Kiichiro ; Yoshimura, Reiji ; Shoji, Yoshihisa ; Hagi, Katsuhiko ; Iwata, Nakao. / Efficacy, Tolerability, and Safety of Blonanserin in Schizophrenia : An Updated and Extended Systematic Review and Meta-Analysis of Randomized Controlled Trials. In: Pharmacopsychiatry. 2019 ; Vol. 52, No. 2. pp. 52-62.
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abstract = "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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Kishi, T, Matsui, Y, Matsuda, Y, Katsuki, A, Hori, H, Yanagimoto, H, Sanada, K, Morita, K, Yoshimura, R, Shoji, Y, Hagi, K & Iwata, N 2019, 'Efficacy, Tolerability, and Safety of Blonanserin in Schizophrenia: An Updated and Extended Systematic Review and Meta-Analysis of Randomized Controlled Trials', Pharmacopsychiatry, vol. 52, no. 2, pp. 52-62. https://doi.org/10.1055/a-0574-0088

Efficacy, Tolerability, and Safety of Blonanserin in Schizophrenia : An Updated and Extended Systematic Review and Meta-Analysis of Randomized Controlled Trials. / Kishi, Taro; Matsui, Yuki; Matsuda, Yuki; Katsuki, Asuka; Hori, Hikaru; Yanagimoto, Hiroko; Sanada, Kenji; Morita, Kiichiro; Yoshimura, Reiji; Shoji, Yoshihisa; Hagi, Katsuhiko; Iwata, Nakao.

In: Pharmacopsychiatry, Vol. 52, No. 2, 07.03.2019, p. 52-62.

Research output: Contribution to journalArticle

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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

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.

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