Ye Jin, Qi Wang, Yan Wang, Mengxi Liu, Anji Sun, Zhongli Geng, Yiwei Lin, Xiaobai Li
{"title":"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","authors":"Ye Jin, Qi Wang, Yan Wang, Mengxi Liu, Anji Sun, Zhongli Geng, Yiwei Lin, Xiaobai Li","doi":"10.11919/j.issn.1002-0829.217044","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Previous clinical trials of α7-nicotinic acetylcholine receptor agonists (α7-nAChR agonists) showed mixed results in treating the cognitive and negative symptoms of schizophrenia.</p><p><strong>Aims: </strong>To assess the efficacy and safety of α7-nAChR agonists in treating the cognitive and negative symptoms in schizophrenia.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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], <i>I<sup>2</sup></i> =88%) and negative symptoms (SMD=0.13 [-0.04, 0.30], <i>I<sup>2</sup></i> =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.</p><p><strong>Conclusion: </strong>α7-nAChR agonists may not be effective in reversing overall cognitive impairments and negative symptoms in patients with schizophrenia as adjunctive therapies.</p>","PeriodicalId":21886,"journal":{"name":"上海精神医学","volume":"29 4","pages":"191-199"},"PeriodicalIF":0.0000,"publicationDate":"2017-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/20/03/sap-29-191.PMC5608991.pdf","citationCount":"14","resultStr":"{\"title\":\"Alpha7 nAChR Agonists for Cognitive Deficit and Negative Symptoms in Schizophrenia: A Meta-analysis of Randomized Double-blind Controlled Trials.\",\"authors\":\"Ye Jin, Qi Wang, Yan Wang, Mengxi Liu, Anji Sun, Zhongli Geng, Yiwei Lin, Xiaobai Li\",\"doi\":\"10.11919/j.issn.1002-0829.217044\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Previous clinical trials of α7-nicotinic acetylcholine receptor agonists (α7-nAChR agonists) showed mixed results in treating the cognitive and negative symptoms of schizophrenia.</p><p><strong>Aims: </strong>To assess the efficacy and safety of α7-nAChR agonists in treating the cognitive and negative symptoms in schizophrenia.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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], <i>I<sup>2</sup></i> =88%) and negative symptoms (SMD=0.13 [-0.04, 0.30], <i>I<sup>2</sup></i> =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.</p><p><strong>Conclusion: </strong>α7-nAChR agonists may not be effective in reversing overall cognitive impairments and negative symptoms in patients with schizophrenia as adjunctive therapies.</p>\",\"PeriodicalId\":21886,\"journal\":{\"name\":\"上海精神医学\",\"volume\":\"29 4\",\"pages\":\"191-199\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2017-08-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/20/03/sap-29-191.PMC5608991.pdf\",\"citationCount\":\"14\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"上海精神医学\",\"FirstCategoryId\":\"95\",\"ListUrlMain\":\"https://doi.org/10.11919/j.issn.1002-0829.217044\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"上海精神医学","FirstCategoryId":"95","ListUrlMain":"https://doi.org/10.11919/j.issn.1002-0829.217044","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Alpha7 nAChR Agonists for Cognitive Deficit and Negative Symptoms in Schizophrenia: A Meta-analysis of Randomized Double-blind Controlled Trials.
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.
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.
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