Long-acting injectable antipsychotics in patients with schizophrenia: systematic review and mixed treatment meta-analysis
, , , , and | Jan 31, 2017
About this article
Article Category: Review article
Published Online: Jan 31, 2017
Page range: 741 - 750
DOI: https://doi.org/10.5372/1905-7415.0906.446
Keywords
© 2015 Osot Nerapusee, Chanadda Chinthammit, Chavalit Romyen, Maneeporn Pangjunhom, Daniel C. Malone, Rungpetch Sakulbumrungsil
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
Figure 1
Figure 2
Summary of data reported in the randomized controlled trials included in our systematic review on long-acting injectable antipsychotics for schizophrenia
| Author | Study ID | Weeks | Total patients | Jadad score | Medication and dose | Total number of patients per arm | Number of patients who have discontinuation | |||
|---|---|---|---|---|---|---|---|---|---|---|
| Relapse | Adverse event | Other reason | No discontinuation | |||||||
| Hirsch et al. | 1 | 81 | 2 | Placebo | 40 | 25 | 0 | 3 | 12 | |
| 1973 [ | Fluphenazine ≥ 25 mg q 4 wks | 41 | 3 | 0 | 4 | 34 | ||||
| Odejide et al. | 2 | 53 | 4 | Placebo | 27 | 15 | 0 | 8 | 4 | |
| 1982 [ | Fluphenazine 50 mg q 4–8 wks | 26 | 5 | 0 | 9 | 12 | ||||
| Sampath et al. | 3 | 16 | 3 | Placebo | 12 | 9 | 0 | 0 | 3 | |
| 1992 [ | Fluphenazine 17–95 mg q 2 wks | 4 | 4 | 0 | 0 | 0 | ||||
| Eberhard et al. | 4 | 32 | 3 | Flupentixol 10–120 mg q 4 wks | 16 | 3 | 0 | 3 | 10 | |
| 1986 [ | Haloperidol 25–300 mg q 4 wks | 16 | 3 | 0 | 3 | 10 | ||||
| Chouinard et al. | 5 | 72 | 5 | Fluphenazine 2.5-300 mg q 2-4 wks | 36 | 0 | 0 | 0 | 36 | |
| 1985, 1989 [ | Haloperidol 15–900 mg q 2–4 wks | 36 | 1 | 0 | 1 | 34 | ||||
| Cookson et al. | 6 | 19 | 5 | Fluphenazine 12.5–37.5 mg q 2–5 wks | 10 | 0 | 2 | 0 | 8 | |
| 1986 [ | Haloperidol 50–100 mg q 2–6 wks | 9 | 2 | 0 | 0 | 7 | ||||
| Jolley et al. | 7 | 54 | 4 | Placebo | 27 | 3 | 0 | 9 | 15 | |
| 1989, 1990 [ | Fluphenazine 25 mg q 4 wks | 27 | 12 | 0 | 15 | 0 | ||||
| Kissling et al. | 8 | 54 | 4 | Haloperidol 80 mg q 4 wks | 32 | 1 | 0 | 9 | 22 | |
| 1985 [ | Fluphenazine 20 mg q 2 wks | 22 | 1 | 5 | 7 | 9 | ||||
| McKane et al. | 9 | 38 | 4 | Haloperidol 120 mg q 4 wks | 19 | 10 | 0 | 8 | 1 | |
| 1987 [ | Fluphenazine 105 mg q 4 wks | 19 | 10 | 1 | 6 | 2 | ||||
| Sharma and Jaigirdar | 10 | 59 | 4 | Haloperidol ≥ 25 mg q 4 wks | 30 | 10 | 4 | 6 | 10 | |
| 1991 [ | Fluphenazine ≥ 25 mg q 4 wks | 29 | 6 | 3 | 3 | 17 | ||||
| Fleischhacker etal. | 11 | 747 | 4 | Risperidone 25–50 mg q 2 wks | 368 | 76 | 23 | 0 | 269 | |
| 2012 [ | Paliperidone 25–100 mg q 4 wks | 379 | 99 | 25 | 0 | 255 | ||||
| Hough et al. | 12 | 408 | 5 | Placebo | 203 | 97 | 2 | 26 | 78 | |
| 2010 [ | Paliperidone 25–100 mg q 4 wks | 205 | 36 | 3 | 27 | 139 | ||||
| Pinto et al. | 13 | 64 | 4 | Flupentixol 36.6 mg three times wk | 31 | 0 | 0 | 0 | 31 | |
| 1979 [ | Fluphenazine 25 mg three times wk | 33 | 0 | 1 | 7 | 25 | ||||
| Wisted et al. | 14 | 32 | 4 | Flupentixol 27 mg q 3 wks | 17 | 0 | 0 | 8 | 9 | |
| 1983 [ | Fluphenazine 31 mg q 3 wks | 15 | 0 | 0 | 6 | 9 | ||||
| Wisted et al. | 15 | 64 | 3 | Zuclopenthixol 100–600 mg q 4 wks | 36 | 4 | 1 | 2 | 29 | |
| 1991 [ | Haloperidol 39–200 mg q 4 wks | 28 | 7 | 1 | 0 | 20 | ||||
| Eklund et al. | 16 | 43 | 3 | Placebo | 23 | 16 | 0 | 0 | 7 | |
| 1991 [ | Haloperidol 60 mg q 4 wks | 20 | 2 | 2 | 1 | 15 | ||||
| Dencker et al. | 17 | 60 | 2 | Zuclopenthixol 50–600 mg q 4 wks | 30 | 3 | 0 | 0 | 27 | |
| 1980 [ | Flupentixol 25–300 mg q 4 wks | 30 | 4 | 0 | 3 | 23 | ||||
Three outcomes of 6 long acting injectable antipsychotics comparison—random effects model and fixed effects model
| Random effects model | Fixed effects model | ||||||
|---|---|---|---|---|---|---|---|
| Probability 52 weeks (SD) | Hazard ratio vs placebo (95%Credible interval) | Probability that the medicine is best in preventing the event | Probability 52 weeks (SD) | Hazard ratio vs placebo (95%Credible interval) | Probability that the medicine is best in preventing the event | ||
| Placebo | 0.49 (0.263) | 1.00 | 0.002 (0.046) | 0.49 (0.263) | 1.00 | 0.00 (0.000) | |
| Fluphenazine | 0.36 (0.312) | 0.56 (0.13,2.08) | 0.10 (0.296) | 0.21 (0.200) | 0.41 (0.26 0.62) | 0.06 (0.240) | |
| Flupentixol | 0.37 (0.329) | 0.55 (0.05,4.92) | 0.12 (0.319) | 0.49 (0.334) | 22.07 (0.12,166.10) | 0.049 (0.217) | |
| Haloperidol | 0.41 (0.330) | 0.71 (0.11,3.60) | 0.07 (0.259) | 0.21 (0.207) | 1.02 (0.23,1.02) | 0.23 (0.419) | |
| Zuclopenthixol | 0.33 (0.328) | 0.32 (0.02,4.95) | 0.18 (0.386) | 0.37 (0.289) | 1.02 (0.07,1.02) | 0.19 (0.395) | |
| Paliperidone | 0.30 (0.314) | 0.29 (0.02, 4.59) | 0.18 (0.387) | 0.21 (0.198) | 1.01 (0.20,1.01) | 0.26 (0.437) | |
| Risperidone | 0.26 (0.321) | 0.22 (0.004,11.16) | 0.35 (0.476) | 0.33 (0.269) | 0.97 (0.14,0.97) | 0.21 (0.409) | |
| Placebo | 0.07 (0.113) | 1.00 | 0.048 (0.213) | 0.07 (0.114) | 1.00 | 0.53 (0.499) | |
| Fluphenazine | 0.11 (0.180) | 1.54 (0.39,6.42) | 0.057 (0.232) | 0.21 (0.256) | 6.19 (0.54,27.41) | 0.001 (0.037) | |
| Flupentixol | 0.09 (0.164) | 1.12 (0.11,7.06) | 0.14 (0.343) | 0.12 (0.187) | 21.85 (0.15,410.40) | 0.12 (0.325) | |
| Haloperidol | 0.07 (0.147) | 0.93 (0.21,4.19) | 0.16 (0.362) | 0.14 (0.204) | 19.64 (0.28, 19.64) | 0.045 (0.208) | |
| Zuclopenthixol | 0.07 (0.159) | 0.50 (0.03,7.05) | 0.31 (0.464) | 0.07 (0.134) | 1.01 (0.05,3.42) | 0.20 (0.403) | |
| Paliperidone | 0.13 (0.213) | 1.25 (0.11,16.55) | 0.10 (0.293) | 0.42 (0.377) | 142.30 (0.25,142.30) | 0.02 (0.145) | |
| Risperidone | 0.12 (0.218) | 1.15 (0.06,23.32) | 0.20 (0.397) | 0.09 (0.161) | 1.06 (0.21,6.73) | 0.08 (0.271) | |
| Placebo | 0.25 (0.246) | 1.00 | 0.051 (0.219) | 0.25 (0.247) | 1.000 | 0.12 (0.320) | |
| Fluphenazine | 0.32 (0.299) | 1.36 (0.58,3.49) | 0.07 (0.251) | 0.41 (0.300) | 2.20 (0.94, 6.22) | 0.002 (0.039) | |
| Flupentixol | 0.31 (0.304) | 1.28 (0.31,5.12) | 0.10 (0.296) | 0.23 (0.263) | 5.32 (0.55,26.61) | 0.19 (0.393) | |
| Haloperidol | 0.31 (0.302) | 1.29 (0.48,4.70) | 0.09 (0.289) | 0.50 (0.317) | 19.47 (0.80, 19.47) | 0.002 (0.042) | |
| Zuclopenthixol | 0.26 (0.295) | 0.68 (0.08,5.93) | 0.24 (0.425) | 0.21 (0.249) | 0.38 (0.15,2.62) | 0.18 (0.386) | |
| Paliperidone | 0.27 (0.286) | 0.80 (0.17,3.85) | 0.15 (0.357) | 0.19 (0.235) | 0.99 (0.51,1.27) | 0.33 (0.471) | |
| Risperidone | 0.31 (0.346) | 0.81 (0.01, 54.22) | 0.31 (0.461) | 0.30 (0.300) | 1.05 (0.04,16.33) | 0.18 (0.382) | |
| Resdevl | 4.9 (42.68) | 168.1 (120.50) | |||||
| Resdev2 | 43.6 (24.40) | -61.3 (92.70) | |||||
| Resdev3 | 56.1 (36.27) | 453.9 (423.70) | |||||
| Total Resdev | 104.7 (45.05) | 560.7 (449.90) | |||||
| Deviance info criteria | 5,269.63 | 36,061.40 | |||||