Alpha7 nAChR Agonists for Cognitive Deficit and Negative Symptoms in Schizophrenia: A Meta-analysis of Randomized Double-blind Controlled Trials.

上海精神医学 Pub Date : 2017-08-25 DOI:10.11919/j.issn.1002-0829.217044

Ye Jin, Qi Wang, Yan Wang, Mengxi Liu, Anji Sun, Zhongli Geng, Yiwei Lin, Xiaobai Li

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引用次数: 14

Abstract

Background: Previous clinical trials of α7-nicotinic acetylcholine receptor agonists (α7-nAChR agonists) showed mixed results in treating the cognitive and negative symptoms of schizophrenia.

Aims: To assess the efficacy and safety of α7-nAChR agonists in treating the cognitive and negative symptoms in schizophrenia.

Methods: A literature search was conducted to identify randomized double-blind placebo-controlled trials for schizophrenia published before May 26, 2017, by searching PubMed, Embase, ClinicalTrials.gov, the Cochrane Library and the Chinese language databases CNKI, Wanfang, and VIP Data. The effects of α7-nAChR agonists were evaluated for overall cognitive function and negative symptoms by calculating standard mean difference (SMDs) between active drugs and placebo added to antipsychotics.

Results: 8 studies with low bias were included. We found no statistically significant effects of α7 nAChR agonists on the overall cognitive function (SMD=-0.10[-0.46, 0.25], I² =88%) and negative symptoms (SMD=0.13 [-0.04, 0.30], I² =64%) in patients with schizophrenia. Sensitivity analysis showed these results to be firm. And this drug is generally safe and well tolerated with no significant difference from placebo based on adverse events (RR=1.02, [0.85, 1.23]) and dropouts (RR=1.04, [0.61, 1.78]) data. Evidence based on outcomes from the meta-analysis was rated as 'moderate' as per the GRADE guidelines.

Conclusion: α7-nAChR agonists may not be effective in reversing overall cognitive impairments and negative symptoms in patients with schizophrenia as adjunctive therapies.

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Alpha7 nAChR激动剂治疗精神分裂症的认知缺陷和阴性症状:随机双盲对照试验的荟萃分析

背景:α7-烟碱乙酰胆碱受体激动剂(α7-nAChR激动剂)在治疗精神分裂症认知症状和阴性症状方面的临床试验结果喜忧参半。目的:评价α7-nAChR激动剂治疗精神分裂症认知及阴性症状的疗效和安全性。方法:通过检索PubMed、Embase、ClinicalTrials.gov、Cochrane Library和中文数据库CNKI、万方、VIP Data，检索2017年5月26日前发表的针对精神分裂症的随机双盲安慰剂对照试验。通过计算活性药物与安慰剂加用抗精神病药物的标准均差(SMDs)，评估α - 7- nachr激动剂对整体认知功能和阴性症状的影响。结果:纳入8项低偏倚研究。我们发现α7 nAChR激动剂对精神分裂症患者整体认知功能(SMD=-0.10[-0.46, 0.25]， I2 =88%)和阴性症状(SMD=0.13 [-0.04, 0.30]， I2 =64%)的影响无统计学意义。敏感性分析表明这些结果是可靠的。从不良事件(RR=1.02，[0.85, 1.23])和退药(RR=1.04，[0.61, 1.78])数据来看，该药总体上是安全的，耐受性良好，与安慰剂无显著差异。根据GRADE指南，基于meta分析结果的证据被评为“中等”。结论:α7-nAChR激动剂作为辅助治疗可能不能有效逆转精神分裂症患者的整体认知障碍和阴性症状。

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来源期刊

上海精神医学

自引率

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发文量

2341

期刊介绍： Shanghai archives of psychiatry (bimonthly) was founded in 1959 and is sponsored by Shanghai Mental Health Center. The journal is aimed at mental health workers across the country, including psychiatrists and nurses, clinical psychologists, social workers, and people who are committed to the cause of mental health. It focuses on reporting clinical research results and practical experience in the field of psychiatry, and introduces the latest knowledge in psychiatry and related fields. The columns include monographs, case reports, clinical case discussions, reviews, mental health and law, and debates and discussions.