Comparative efficacy of pharmacological treatments in the maintenance treatment of bipolar disorder: a systematic review and network Meta-analysis
10.3760/cma.j.cn113661-20200326-00145
- VernacularTitle:双相障碍维持期药物临床疗效的系统评价和网络Meta分析
- Author:
Yaqi SUN
1
;
Yumei WANG
;
Tong LYU
;
Ziyang WANG
;
Xuan ZHAI
;
Lu HAN
;
Xiaoling QIAO
;
Yu SU
;
Yanping BAO
;
Wei YAN
;
Lin LU
;
Xueyi WANG
Author Information
1. 河北医科大学精神卫生中心 河北医科大学精神卫生研究所 河北省脑老化与认知神经科学实验室，石家庄 050031
- Publication Type:Journal Article
- Keywords:
Bipolar disorder;
Drug therapy;
Network Meta-analysis
- From:
Chinese Journal of Psychiatry
2020;53(6):527-536
- CountryChina
- Language:Chinese
-
Abstract:
Objective:Network meta-analyses (NMA) were used to evaluate and compare the effectiveness and acceptability of 20 maintenance treatment strategies for bipolar disorder (BD), such as lithium, imipramine, lithium+imipramine, carbamazepine, lithium+carbamazepine, valproic acid salt, lamotrigine, fluoxetine, olanzapine, aripiprazole, oxcarbazepine, quetiapine, lithium+valproic acid, risperidone long-acting injection, lamotrigine+valproic acid salt, aripiprazole+lamotrigine, paliperidone, ziprasidone, lurasidone, quetiapine sustained release.Methods:The Literatures were systematically searched from PubMed, EMBASE, PsycINFO, China national knowledge infrastructure (CNKI), Wanfang data (Wanfang), China biology medicine disc (CBMdisc) until 11/21/2019. Randomized controlled studies of the maintenance therapy with single or combination drugs for at least 12 weeks were selected. The primary outcome was the proportion of patients who got recurrence in the total number of patients. Efficacy of pharmacological treatments was assessed during the maintenance treatment treatments by using a random-effects network meta-analysis model within a Frequentists framework. Data analysis was performed in Stata 14.0 software.Results:40 studies covering with 10 431 patients were included, and 20 kinds of maintenance treatments for BD were performed. In terms of clinical efficacy, the top 5 treatments were lurasidone,quetiapine, olazanpine, lithium+carbamazepine, aripiprazole+lamotrigine.lithium ( RR:0.78, 95% CI: 0.62-0.97), olanzapine ( RR:0.51, 95% CI: 0.35-0.75), quetiapine ( RR:0.50, 95% CI: 0.33-0.74) and lurasidone ( RR:0.40, 95% CI: 0.19-0.83) were significantly superior to placebo. Conclusions:Lithium, olanzapine, quetiapine and lurasidone may be more effective than placebo,.but the efficaly of other monotherapy and combination therapy strategies need to be proven.
