Comparison of brexpiprazole, aripiprazole, and placebo for Japanese major depressive disorder: A systematic review and network meta-analysis.

IF 2 Q3 NEUROSCIENCES
Neuropsychopharmacology Reports Pub Date : 2024-03-01 Epub Date: 2024-01-14 DOI:10.1002/npr2.12414
Taro Kishi, Kenji Sakuma, Takeo Saito, Atsuo Nakagawa, Masaki Kato, Nakao Iwata
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引用次数: 0

Abstract

Aim: This systematic review and frequentist network meta-analysis used random-effects models is conducted to determine whether there are differences in the efficacy, acceptability, tolerability, and safety profiles of brexpiprazole (BRE) and aripiprazole (ARI) for Japanese with major depressive disorder (MDD) who were inadequately responsive to antidepressants.

Methods: Outcome measures were scores on the Montgomery Åsberg Depression Rating Scale (primary), the Clinical Global Impression severity scale, and social functioning scale; the non-response rate; the non-remission rate; all-cause discontinuation; discontinuation due to adverse events (DAE); at least one adverse event (1AE); serious adverse event, akathisia; tremor; weight gain.

Results: A literature search identified three double-blind, randomized, placebo-controlled trials. These comprised one BRE study (with a 1 mg/day [BRE1] and a 2 mg/day [BRE2]) and two ARI studies (with a 3 mg/day arm and a flexible-dose arm[within the dosage range approved in Japan]) (n = 1736). Both BRE and ARI demonstrated better efficacy than the placebo. BRE but not ARI had a higher DAE than the placebo. ARI but not BRE had a higher 1AE than the placebo. BRE and ARI had a higher risk of akathisia and weight gain than the placebo. There were no significant differences between BRE and ARI for any of the outcomes. Although BRE1 had good efficacy, it carried risk of weight gain. Although BRE2 also had efficacy, it carried risks of DAE, akathisia, and weight gain. However, the risk of akathisia in BRE2 was reduced by an initial dose of 0.5 mg/day rather than 1.0 mg/day.

Conclusions: Overall BRE showed similar utility to ARI and a good risk-benefit balance.

比较布雷克哌唑、阿立哌唑和安慰剂对日本重度抑郁障碍的治疗效果:系统综述和网络荟萃分析。
目的:本研究采用随机效应模型进行系统综述和频数网络荟萃分析,以确定布雷克哌唑(BRE)和阿立哌唑(ARI)对抗抑郁药反应不足的日本重度抑郁障碍(MDD)患者的疗效、可接受性、耐受性和安全性是否存在差异:结果:结果测量指标包括蒙哥马利-奥斯伯格抑郁评分量表(主要)、临床总体印象严重程度量表和社会功能量表的评分;无反应率;无缓解率;全因停药;因不良事件(DAE)停药;至少一种不良事件(1AE);严重不良事件、运动障碍;震颤;体重增加:文献检索发现了三项双盲、随机、安慰剂对照试验。其中包括一项 BRE 研究(1 毫克/天 [BRE1] 和 2 毫克/天 [BRE2])和两项 ARI 研究(3 毫克/天组和灵活剂量组[在日本批准的剂量范围内])(n = 1736)。BRE 和 ARI 的疗效均优于安慰剂。BRE的DAE高于安慰剂,但ARI的DAE不高于安慰剂。ARI(而非 BRE)的 1AE 高于安慰剂。与安慰剂相比,BRE 和 ARI 出现运动迟缓和体重增加的风险更高。BRE 和 ARI 在任何结果上都没有明显差异。虽然 BRE1 具有良好的疗效,但有体重增加的风险。虽然 BRE2 也有疗效,但它存在 DAE、抽搐和体重增加的风险。然而,BRE2 的初始剂量为 0.5 毫克/天,而不是 1.0 毫克/天,从而降低了运动障碍的风险:总体而言,BRE 的效用与 ARI 相似,且风险-效益平衡良好。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Neuropsychopharmacology Reports
Neuropsychopharmacology Reports Psychology-Clinical Psychology
CiteScore
3.60
自引率
4.00%
发文量
75
审稿时长
14 weeks
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