Abstract
Background Hyperprolactinaemia is a common antipsychotic (AP)-induced adverse effect, particularly in female patients. Aims This meta-analysis examined the efficacy and safety of adjunctive aripiprazole in preventing AP-related hyperprolactinaemia in patients with first-episode schizophrenia. Methods PubMed, PsycINFO, EMBASE, Cochrane Library, WanFang and China Journal Net databases were searched to identify eligible randomised controlled trials (RCTs). Primary outcomes were the reductions of serum prolactin level and prolactin-related symptoms. Data were independently extracted by two reviewers and analysed using RevMan (V.5.3). Weighted/standardised mean differences (WMDs/SMDs)±95% CIs were reported. Results In the five RCTs (n=400), the adjunctive aripiprazole (n=197) and the control groups (n=203) with a mean of 11.2 weeks of treatment duration were compared. The aripiprazole group had a significantly lower endpoint serum prolactin level in all patients (five RCTs, n=385; WMD: -50.43 ng/mL (95% CI: -75.05 to -25.81), p<0.00001; I 2 =99%), female patients (two RCTs, n=186; WMD: -22.58 ng/mL (95% CI: -25.67 to -19.49), p<0.00001; I 2 =0%) and male patients (two RCTs, n=127; WMD: -68.80 ng/mL (95% CI: -100.11 to -37.49), p<0.0001). In the sensitivity analysis for the endpoint serum prolactin level in all patients, the findings remained significant (p<0.00001; I 2 =96%). The aripiprazole group was superior to the control group in improving negative symptoms as assessed by the Positive and Negative Syndrome Scale (three RCTs, n=213; SMD: -0.51 (95% CI: -0.79 to -0.24), p=0.0002; I 2 =0%). Adverse effects and discontinuation rates were similar between the two groups. Conclusions Adjunctive aripiprazole appears to be associated with reduced AP-induced hyperprolactinaemia and improved prolactin-related symptoms in first-episode schizophrenia. Further studies with large sample sizes are needed to confirm these findings.
| Original language | English |
|---|---|
| Article number | e100091 |
| Journal | General Psychiatry |
| Volume | 32 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - 1 Oct 2019 |
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Adjunctive aripiprazole for antipsychotic-related hyperprolactinaemia in patients with first-episode schizophrenia : A meta-analysis. / Zheng, Wei; Cai, Dong Bin; Yang, Xin Hu; Ungvari, Gabor S.; Ng, Chee H.; Shi, Zhan Ming; Hu, Mei Ling; Ning, Yu Ping; Xiang, Yu Tao.
In: General Psychiatry, Vol. 32, No. 5, e100091, 01.10.2019.Research output: Contribution to journal › Article
TY - JOUR
T1 - Adjunctive aripiprazole for antipsychotic-related hyperprolactinaemia in patients with first-episode schizophrenia
T2 - A meta-analysis
AU - Zheng, Wei
AU - Cai, Dong Bin
AU - Yang, Xin Hu
AU - Ungvari, Gabor S.
AU - Ng, Chee H.
AU - Shi, Zhan Ming
AU - Hu, Mei Ling
AU - Ning, Yu Ping
AU - Xiang, Yu Tao
PY - 2019/10/1
Y1 - 2019/10/1
N2 - Background Hyperprolactinaemia is a common antipsychotic (AP)-induced adverse effect, particularly in female patients. Aims This meta-analysis examined the efficacy and safety of adjunctive aripiprazole in preventing AP-related hyperprolactinaemia in patients with first-episode schizophrenia. Methods PubMed, PsycINFO, EMBASE, Cochrane Library, WanFang and China Journal Net databases were searched to identify eligible randomised controlled trials (RCTs). Primary outcomes were the reductions of serum prolactin level and prolactin-related symptoms. Data were independently extracted by two reviewers and analysed using RevMan (V.5.3). Weighted/standardised mean differences (WMDs/SMDs)±95% CIs were reported. Results In the five RCTs (n=400), the adjunctive aripiprazole (n=197) and the control groups (n=203) with a mean of 11.2 weeks of treatment duration were compared. The aripiprazole group had a significantly lower endpoint serum prolactin level in all patients (five RCTs, n=385; WMD: -50.43 ng/mL (95% CI: -75.05 to -25.81), p<0.00001; I 2 =99%), female patients (two RCTs, n=186; WMD: -22.58 ng/mL (95% CI: -25.67 to -19.49), p<0.00001; I 2 =0%) and male patients (two RCTs, n=127; WMD: -68.80 ng/mL (95% CI: -100.11 to -37.49), p<0.0001). In the sensitivity analysis for the endpoint serum prolactin level in all patients, the findings remained significant (p<0.00001; I 2 =96%). The aripiprazole group was superior to the control group in improving negative symptoms as assessed by the Positive and Negative Syndrome Scale (three RCTs, n=213; SMD: -0.51 (95% CI: -0.79 to -0.24), p=0.0002; I 2 =0%). Adverse effects and discontinuation rates were similar between the two groups. Conclusions Adjunctive aripiprazole appears to be associated with reduced AP-induced hyperprolactinaemia and improved prolactin-related symptoms in first-episode schizophrenia. Further studies with large sample sizes are needed to confirm these findings.
AB - Background Hyperprolactinaemia is a common antipsychotic (AP)-induced adverse effect, particularly in female patients. Aims This meta-analysis examined the efficacy and safety of adjunctive aripiprazole in preventing AP-related hyperprolactinaemia in patients with first-episode schizophrenia. Methods PubMed, PsycINFO, EMBASE, Cochrane Library, WanFang and China Journal Net databases were searched to identify eligible randomised controlled trials (RCTs). Primary outcomes were the reductions of serum prolactin level and prolactin-related symptoms. Data were independently extracted by two reviewers and analysed using RevMan (V.5.3). Weighted/standardised mean differences (WMDs/SMDs)±95% CIs were reported. Results In the five RCTs (n=400), the adjunctive aripiprazole (n=197) and the control groups (n=203) with a mean of 11.2 weeks of treatment duration were compared. The aripiprazole group had a significantly lower endpoint serum prolactin level in all patients (five RCTs, n=385; WMD: -50.43 ng/mL (95% CI: -75.05 to -25.81), p<0.00001; I 2 =99%), female patients (two RCTs, n=186; WMD: -22.58 ng/mL (95% CI: -25.67 to -19.49), p<0.00001; I 2 =0%) and male patients (two RCTs, n=127; WMD: -68.80 ng/mL (95% CI: -100.11 to -37.49), p<0.0001). In the sensitivity analysis for the endpoint serum prolactin level in all patients, the findings remained significant (p<0.00001; I 2 =96%). The aripiprazole group was superior to the control group in improving negative symptoms as assessed by the Positive and Negative Syndrome Scale (three RCTs, n=213; SMD: -0.51 (95% CI: -0.79 to -0.24), p=0.0002; I 2 =0%). Adverse effects and discontinuation rates were similar between the two groups. Conclusions Adjunctive aripiprazole appears to be associated with reduced AP-induced hyperprolactinaemia and improved prolactin-related symptoms in first-episode schizophrenia. Further studies with large sample sizes are needed to confirm these findings.
KW - aripiprazole
KW - first episode
KW - meta-analysis
KW - prolactin
KW - schizophrenia
UR - http://www.scopus.com/inward/record.url?scp=85073720102&partnerID=8YFLogxK
U2 - 10.1136/gpsych-2019-100091
DO - 10.1136/gpsych-2019-100091
M3 - Article
VL - 32
JO - General Psychiatry
JF - General Psychiatry
SN - 2096-5923
IS - 5
M1 - e100091
ER -