Efficacy and safety of aripiprazole in the treatment of antipsychotic-induced hyperprolactinemia: a meta-analysis
10.3760/cma.j.cn114015-20210927-01023
- VernacularTitle:阿立哌唑治疗抗精神病药相关高催乳素血症有效性和安全性的meta分析
- Author:
Hao REN
1
;
Jianfu ZHU
;
Haitang QIU
Author Information
1. 重庆市长寿区第三人民医院精神科，重庆 401220
- Publication Type:Journal Article
- Keywords:
Aripiprazole;
Antipsychotic agents;
Prolactin;
Hyperprolactinemia;
Meta-analysis
- From:
Adverse Drug Reactions Journal
2022;24(4):175-184
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the efficacy and safety of aripiprazole in the treatment of antipsychotic-induced hyperprolactinemia (AIH).Methods:Randomized controlled trials (RCTs) of aripiprazole in treating AIH were collected by searching relevant databases at home and abroad (up to November 29, 2020). Patients in the trial group was treated with aripiprazole on the base antipsychotic drugs, and those in the control group was treated with or without additional placebo. Outcome indicators included serum prolactin normalization rate, serum prolactin level, and the incidence of major adverse events. Meta-analysis was performed using RevMan 5.4 software. The effect size of counting data was risk ratio ( RR) and its 95% confidence interval ( CI), and the effect size of measurement data was standardized mean difference ( SMD) and its 95 %CI. Results:A total of 23 RCTs were entered in the analysis, including 1 530 patients, 816 patients in the trial group and 714 patients in the control group. The meta-analysis results showed that the normalization rate of serum prolactin in the trial group was higher than that in the control group at the end of the treatment course (4-24 weeks) [73.5% (150/204) vs. 4.1% (8/194), RR=16.58, 95 %CI: 8.61-31.93, P<0.001]. According to the dose of aripiprazole, the patients were divided into 5 mg/d and 10 mg/d subgroups. The analysis results showed that the serum prolactin levels in patients in the 2 trial subgroups were lower than those in their corresponding control groups at the end of the treatment, and the differences were statistically significant [ SMD= -1.25, 95 %CI: -1.66- -0.84, P<0.001; SMD=1.93, 95 %CI: -2.38- -1.48, P<0.001]. There were no significant differences in the incidence of overall adverse events, extrapyramidal reactions, insomnia, somnolence, and weight gain in patients between the trial and control groups during the trial [26.5% (103/388) vs. 24.1% (94/390), RR=1.10, 95 %CI: 0.90-1.36, P=0.35; 26.0% (53/204) vs. 34.0% (70/206), RR=0.77, 95 %CI: 0.58-1.02, P=0.06; 8.4% (31/368) vs. 9.9% (37/372), RR=0.86, 95 %CI: 0.56-1.33, P=0.50; 5.6% (19/340) vs. 4.7% (16/342), RR=1.16, 95 %CI: 0.64-2.12, P=0.63; 0 vs. 7.9% (7/89), RR=0.18, 95 %CI: 0.03-0.99), P=0.05]. Conclusion:Aripiprazole is safe and effective in the treatment of AIH, but the long-term efficacy and safety need to be explored.
