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Instituto Nacional de Neurología y Neurocirugía

2023, Number 2

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Arch Neurocien 2023; 28 (2)

Comparative efficacy of first and second generation long-acting injectable antipsychotic in schizophrenic patients: a systematic review and network meta-analysis

Saucedo-Uribe E, González-Mallozzi PJ, Medrano-Garza RR, Díaz González-Colmenero F, Carranza-Navarro F, Castillo-Morales PL, Leyva-Camacho PC, Herrera-Montemayor Y, Vidal-Tijerina M, Enríquez-Navarro MK, Medrano SB, Fernández-Zambrano SM, Mancías- Guerra CM, Saucedo-Mancías CL, Sánchez-Ramírez MR

Language: English
References: 24
Page: 35-43
PDF size: 570.73 Kb.


ABSTRACT

Introduction: Long-acting injectable antipsychotics (LAIA) can influence the course of treatment and have the potential to improve treatment adherence. This systematic review and network meta-analysis aimed to evaluate the efficacy of second-generation LAIAs (SG-LAIAs) and first-generation LAIAs (FG-LAIAs) in the treatment of schizophrenia. Methods: The present study adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and is registered in Prospero (ID CRD42019128700). A comprehensive search was conducted in Medline, Embase, Web of Science, and Scopus databases. The search encompassed the period from June 17, 2020, with an update from June 2020 until September 14, 2021. Results: The standardized mean differences (SMDs) for four antipsychotics (80%) demonstrated significant reductions in PANSS scores compared to the placebo. The SMDs ranged from -0.72 (95% CrI -0.99 to -0.46) for haloperidol to -0.45 (-0.54 to -0.37) for paliperidone. Eight studies provided usable results for both negative and positive symptoms, involving a comparison of four antipsychotics. The SMDs for three antipsychotics (75%) significantly reduced negative symptoms compared to placebo, ranging from -0.40 (95% CrI -0.53 to -0.26) for aripiprazole to -0.32 (-0.44 to -0.19) for risperidone. The SMDs for the three drugs (100%) that significantly reduced positive symptoms compared to placebo ranged from -0.50 (95% CrI -0.63 to -0.37) for aripiprazole to -0.19 (-0.57 to 0.20) for zuclopenthixol. Discussion: Our findings suggest that all long-acting injectable antipsychotics, except for zuclopenthixol, exhibit comparable efficacy in symptom reduction. Conclusions: The majority of LAIAs demonstrate similar effectiveness in reducing overall symptoms, and the differences between individual LAIAs are not statistically significant.


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