TY - JOUR
T1 - Association between discontinuation due to withdrawal of consent and use of long-acting injectable antipsychotics
T2 - A meta-analysis of randomized trials for schizophrenia
AU - Kishi, Taro
AU - Sakuma, Kenji
AU - Okuya, Makoto
AU - Iwata, Nakao
N1 - Funding Information:
The authors declare no conflicts of interest in relation to the subject of this study. We have had the following interests within the past 3 years: Dr. Kishi received speaker’s honoraria from Daiichi Sankyo, Dainippon Sumitomo, Eisai, Janssen, Otsuka, Meiji, Mochida, MSD, and Tanabe-Mitsubishi (Yoshitomi) as well as research grants from the Japanese Ministry of Health, Labour and Welfare, Grant-in-Aid for Scientific Research (C) (19K08082), and Fujita Health University School of Medicine; Dr. Sakuma received speaker’s honoraria from Eisai, Kissei, Meiji, Otsuka, and Torii and received a Fujita Health University School of Medicine research grant and a Grant-in-Aid for Young Scientists (B); Dr. Okuya received speaker’s honoraria from Meiji; and Dr. Iwata received speaker’s honoraria from Astellas, Dainippon Sumitomo, Eli Lilly, GlaxoSmithKline, Janssen, Yoshitomi, Otsuka, Meiji, Shionogi, Novartis, and Pfizer as well as research grants from Eisai, Takeda, Dainippon Sumitomo, and Otsuka.
Funding Information:
This work was supported by a Grant-in-Aid for Scientific Research (C) (19K08082).
PY - 2021/1
Y1 - 2021/1
N2 - We investigated the association between discontinuation due to withdrawal of consent (DWC) in schizophrenia trials and the use of long-acting injectable antipsychotics (LAI-APs). In two categorical meta-analyses of randomized controlled trials, we compared DWC: individual and pooled LAI-APs vs. (1) placebo and (2) oral antipsychotics (OAPs). We also performed conducted a single-group meta-analysis to calculate the average DWC and a meta-regression analysis to examine the association between the results of the meta-analyses and factors related to study design, treatment, and patients. We identified 52 studies (total adult patients = 18,675, LAI-APs = 12,613, placebo = 2,083, and OAPs = 3979; median study duration = 32 weeks). DWC was higher for LAI-aripiprazole than for the placebo [risk ratio (95% confidence interval) = 1.70 (1.23–2.39)]. Neither pooled nor individual LAI-APs differed from the placebo for fluphenazine, olanzapine, paliperidone, and risperidone or from the OAPs for aripiprazole, fluphenazine, haloperidol, olanzapine, paliperidone, risperidone, and zuclopenthixol. The average DWC of each LAI-AP was as follows: LAI-aripiprazole = 10.98%, LAI-fluphenazine = 7.65%, LAI-flupenthixol = 3.33%, LAI-haloperidol = 6.71%, LAI-olanzapine = 10.50%, LAI-paliperidone = 10.38%, LAI-perphenazine = 7.06%, LAI-risperidone = 10.39%, LAI-zuclopenthixol = 4.45%, pooled LAI-APs = 9.88%, and placebo = 11.17%. Meta-regression analysis demonstrated that publication year (β = 0.019), percentage of males (β = 0.020), and mean age (β = 0.045) were associated with an average DWC for pooled LAI-APs. Study duration (β = −0.028), percentage of males (β = 0.078), and patient status (β = −0.847) were associated with an average DWC for LAI-aripiprazole. Presence of a placebo arm (β = 1.596) was associated with an average DWC for LAI-fluphenazine. LAI-AP use was unlikely to be associated with DWC. Although the LAI-aripiprazole had a higher DWC than did the placebo, its average DWC was similar to other those of LAI-APs.
AB - We investigated the association between discontinuation due to withdrawal of consent (DWC) in schizophrenia trials and the use of long-acting injectable antipsychotics (LAI-APs). In two categorical meta-analyses of randomized controlled trials, we compared DWC: individual and pooled LAI-APs vs. (1) placebo and (2) oral antipsychotics (OAPs). We also performed conducted a single-group meta-analysis to calculate the average DWC and a meta-regression analysis to examine the association between the results of the meta-analyses and factors related to study design, treatment, and patients. We identified 52 studies (total adult patients = 18,675, LAI-APs = 12,613, placebo = 2,083, and OAPs = 3979; median study duration = 32 weeks). DWC was higher for LAI-aripiprazole than for the placebo [risk ratio (95% confidence interval) = 1.70 (1.23–2.39)]. Neither pooled nor individual LAI-APs differed from the placebo for fluphenazine, olanzapine, paliperidone, and risperidone or from the OAPs for aripiprazole, fluphenazine, haloperidol, olanzapine, paliperidone, risperidone, and zuclopenthixol. The average DWC of each LAI-AP was as follows: LAI-aripiprazole = 10.98%, LAI-fluphenazine = 7.65%, LAI-flupenthixol = 3.33%, LAI-haloperidol = 6.71%, LAI-olanzapine = 10.50%, LAI-paliperidone = 10.38%, LAI-perphenazine = 7.06%, LAI-risperidone = 10.39%, LAI-zuclopenthixol = 4.45%, pooled LAI-APs = 9.88%, and placebo = 11.17%. Meta-regression analysis demonstrated that publication year (β = 0.019), percentage of males (β = 0.020), and mean age (β = 0.045) were associated with an average DWC for pooled LAI-APs. Study duration (β = −0.028), percentage of males (β = 0.078), and patient status (β = −0.847) were associated with an average DWC for LAI-aripiprazole. Presence of a placebo arm (β = 1.596) was associated with an average DWC for LAI-fluphenazine. LAI-AP use was unlikely to be associated with DWC. Although the LAI-aripiprazole had a higher DWC than did the placebo, its average DWC was similar to other those of LAI-APs.
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U2 - 10.1016/j.jpsychires.2020.10.009
DO - 10.1016/j.jpsychires.2020.10.009
M3 - Article
AN - SCOPUS:85092908156
VL - 132
SP - 144
EP - 150
JO - Journal of Psychiatric Research
JF - Journal of Psychiatric Research
SN - 0022-3956
ER -